scholarly journals Effect of Chronic Kidney Disease on Outcomes of Adult Patients Admitted With Hyperosmolar Hyperglycemic State: Analysis of National Inpatient Sample

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A424-A425
Author(s):  
Hafeez Shaka ◽  
Genaro Velazquez ◽  
Sujitha Velagapudi ◽  
Ehizogie Edigin ◽  
Mukunthan Murthi ◽  
...  
Keyword(s):  
Septic Shock ◽  
Hospital Mortality ◽  
Length Of Hospital Stay ◽  
Volume Overload ◽  
Fluid Replacement ◽  
Hospital Charges ◽  
Secondary Diagnosis ◽  
Inpatient Mortality ◽  
Total Hospital ◽  
Secondary Outcomes

Abstract Background: Treatment guidelines have been well established in patients with HHS and a normal renal function. The mainstay of treatment for patients with HHS includes intravenous volume replacement, potassium replacement, and blood glucose correction by administering insulin. However, this treatment protocol cannot be directly applied to a patient with decreased GFR as it increases the risk of hypoglycemic episodes due to decreased insulin clearance along with increasing the risk of hyperkalemia and volume overload. Hence titrating insulin, maintaining euvolemia and normokalemia becomes further challenging in a patient with HHS in the setting of CKD. Although the above-mentioned complications are well described in multiple studies, there is not enough evidence demonstrating the association between the inpatient mortality and secondary outcomes in patients with HHS with and without CKD. Objective: To compare the inpatient mortality and secondary outcomes in patients admitted with HHS with CKD vs without CKD. Methods: A retrospective cohort study was conducted using the Nationwide Inpatient Sample from 2016 and 2017. About 42 740 hospitalizations who had HHS as primary diagnosis were enrolled and further stratified based on the presence or absence of CKD as a secondary diagnosis using ICD-10 codes. The primary outcome was inpatient mortality and secondary outcomes included length of hospital stay, total Hospital charges, Sepsis, Septic Shock, Acute Kidney Injury (AKI), and Acute Respiratory Failure (ARF). Multivariate regression analysis was done to adjust for confounders. Results: Out of the 42 740 hospitalizations with HHS, about 9 545 had CKD. The in-hospital mortality for patients with HHS was 305 overall, out of which 105 patients had Atrial Fibrillation as a secondary diagnosis. Compared with patients without CKD, patients with CKD had similar in-hospital mortality (aOR 0.93, 95% CI 0.48–1.8, p=0.83) when adjusted for patient and hospital characteristics. Patients with HHS and CKD had similar length of hospital stay, total hospital charges, rate of Sepsis, Septic Shock, and ARF in comparison to patients without CKD; however, patients with CKD had higher odds of developing AKI thorough out hospitalization. Conclusion: This study found that patients admitted with HHS and CKD have similar in-hospital mortality when compared to patients without CKD. However, the study group with CKD has higher odds of developing AKI when compared to the group without CKD. Although AKI is common and correctable in HHS, the above-mentioned association is possible due to the judicious IV fluid replacement in an HHS patient with CKD as a concern for volume overload. Further studies are needed to identify contributing risk factors and establishing fluid replacement guidelines in a patient with HHS and CKD.

scholarly journals In-Hospital Outcomes in Patients With Hyperosmolar Hyperglycemic State With and Without Hypertriglyceridemia: Analysis of National Inpatient Sample

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A426-A426
Author(s):  
Genaro Velazquez ◽  
Hafeez Shaka ◽  
Mukunthan Murthi ◽  
Iriagbonse Asemota ◽  
Sujitha Velagapudi ◽  
...  
Keyword(s):  
Septic Shock ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Hospital Charges ◽  
Secondary Diagnosis ◽  
Total Hospital ◽  
Mortality And Morbidity ◽  
Lower Odds ◽  
Hyperosmolar Hyperglycemic State

Abstract Background: In patients hospitalized with Hyperosmolar hyperglycemic state (HHS) the presence of comorbid conditions including hypertension, heart disease, stroke, and dementia have been variably reported to be associated with higher mortality. HTG is increasingly prevalent in patients with DM, especially those with poor glycemic control who are more likely to suffer from HHS. Elevated triglyceride levels have independently been associated with higher mortality in certain conditions like coronary artery disease and acute pancreatitis. However, data on the effect of Hypertriglyceridemia (HTG) on mortality and morbidity in hospitalized patients with HHS is sparse. Objective: We wanted to compare the outcomes for HHS hospitalizations for patients with and without HTG. Methods: A retrospective cohort study was conducted using the Nationwide Inpatient Sample from 2016 and 2017. About 42 740 hospitalizations who had HHS as primary diagnosis were enrolled and further stratified based on the presence or absence of HTG as secondary diagnosis using ICD-10 codes. The primary outcome was inpatient mortality and secondary outcomes included length of hospital stay, total Hospital charges, Sepsis, Septic Shock, Acute Kidney Injury (AKI), and Acute Respiratory Failure (ARF). Multivariate regression analysis was done to adjust for confounders. Results: Out of the 42 740 hospitalizations with HHS, about 17 040 had HTG. The in-hospital mortality for patients with HHS was 305 overall, out of which 70 patients had HTG as secondary diagnosis. Compared with patients without HTG, patients with HTG had lower odds of in- hospital mortality (0.30, 95% CI 0.157–0.56, p<0.005) when adjusted for patient and hospital characteristics. Patients with HHS and HTG had decreased length of hospital stay, less total Hospital charges, lower odds of Sepsis and Septic Shock, but similar odds of AKI and ARF in comparison to patients without HTG. Conclusion: Our study shows that HTG is associated with lower odds of in-hospital mortality in patients with HHS, even though the odds of AKI and ARF was same in both groups. A similar inverse relationship has already been reported between TG levels and mortality in stroke patients. Though the mechanism of this effect is unclear, one possible explanation could be that patients with HTG are more likely to be treated with statins and fibrates which have known anti-inflammatory effects. Further studies are required to evaluate this possible positive prognostic effect of TG.

scholarly journals Impact of Atrial Fibrillation on In-Hospital Outcomes in Patients With Hyperosmolar Hyperglycemic State: Analysis of National Inpatient Sample

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A425-A426
Author(s):  
Genaro Velazquez ◽  
Hafeez Shaka ◽  
Mukunthan Murthi ◽  
Hernan Marcos-Abdala ◽  
Sujitha Velagapudi ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Septic Shock ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Hospital Charges ◽  
Secondary Diagnosis ◽  
Total Hospital ◽  
Hospital Outcomes ◽  
Hyperosmolar Hyperglycemic State

Abstract Introduction: Atrial fibrillation (AF) is the most common cardiac arrhythmia and its negative prognostic impact on the morbidity and mortality of hospitalized patients has been well described. In patients with Hyperosmolar hyperglycemic state (HHS), mortality rates can reach up to 20% and poor outcomes have been reported in people with older age, presence of comorbid conditions and concurrent infections. However, the impact of atrial fibrillation on the hospital outcomes of patients admitted with HHS has not been well documented. Objective: We wanted to compare the outcomes for HHS hospitalizations for patients with and without Atrial fibrillation. Methods: A retrospective cohort study was conducted using the Nationwide Inpatient Sample from 2016 and 2017. About 42 740 hospitalizations who had HHS as primary diagnosis were enrolled and further stratified based on the presence or absence of Atrial Fibrillation as secondary diagnosis using ICD-10 codes. The primary outcome was inpatient mortality and secondary outcomes included length of hospital stay, total Hospital charges, Sepsis, Septic Shock, Acute Kidney Injury (AKI), and Acute Respiratory Failure (ARF). Multivariate regression analysis was done to adjust for confounders. Results: Out of the 42 740 hospitalizations with HHS, about 3 295 had Atrial Fibrillation. The in-hospital mortality for patients with HHS was 305 overall, out of which 60 patients had Atrial Fibrillation as secondary diagnosis. Compared with patients without Atrial Fibrillation, patients with Atrial Fibrillation had a similar in- hospital mortality (aOR 0.77, 95% CI 0.39–1.52, p=0.45) when adjusted for patient and hospital characteristics. Patients with HHS and Atrial Fibrillation had similar length of hospital stay, total Hospital charges, rate of Sepsis, Septic Shock, AKI, and ARF in comparison to patients without Atrial Fibrillation. Conclusion: Our study suggests that the presence of atrial fibrillation in hospitalized HHS patients is not associated with increased mortality or longer duration of hospital stay. This data is essential since it helps identify HHS patients with increased risk of complications. As previous reports have suggested that AF, especially of new onset in critically ill patients is a marker of increased disease severity, the lack of such impact in patients with HHS requires further studies.

scholarly journals Outcomes in Hospitalizations for Patients Admitted With Hyperosmolar Hyperglycemic State and Obesity: Analysis of National Inpatient Sample

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A428-A429
Author(s):  
Hafeez Shaka ◽  
Genaro Velazquez ◽  
Hernan Gerardo Marcos-Abdala ◽  
Ehizogie Edigin ◽  
Iriagbonse Asemota ◽  
...  
Keyword(s):  
Septic Shock ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Adverse Outcomes ◽  
Hospital Charges ◽  
Obese Patients ◽  
Secondary Diagnosis ◽  
Total Hospital ◽  
Significant Difference

Abstract Introduction: Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHS) is a highly lethal disease with an estimated mortality rate of up to 20%. Although mortality has decreased in recent years, its incidence has increased in the setting of a higher prevalence of underlying conditions that have been previously well described, such as uncontrolled diabetes, Obesity, and a high-carbohydrate diet. All these comorbidities usually overlap with acute complications such as infections or dehydration, which incite the onset of HHS. Currently, limited literature exists for the role of obesity in mortality, hospital stay, and other adverse outcomes in patients with HHS. It is important to know which underlying conditions truly affect outcomes for patients being treated for this condition so further studies can be done, and treatment optimized. Objective: We aim to prove if obesity plays a role in increasing mortality and secondary adverse outcomes in patients with HHS compared to non-obese patients. Methods: A retrospective cohort study was conducted using the Nationwide Inpatient Sample from 2016 and 2017. 42,740 hospitalizations who had HHS as primary diagnosis were enrolled and further stratified based on the presence or absence of Obesity as a secondary diagnosis using ICD-10 codes. The primary outcome was inpatient mortality and secondary outcomes included length of hospital stay, total hospital charges, Sepsis, Septic Shock, Acute Kidney Injury (AKI), and Acute Respiratory Failure (ARF). Multivariate regression analysis was done to adjust for confounders. Results: Out of the 42 740 hospitalizations with HHS, 9,630 had Obesity. The in-hospital mortality for patients with HHS was 45 overall, out of which 45 patients had Obesity as a secondary diagnosis. Compared with patients without Obesity, non-obese patients had similar in-hospital mortality (OR 0.77, 95% CI 0.39–1.52, p=0.45) when adjusted for patient and hospital characteristics. Patients with HHS and Obesity had similar lengths of hospital stay, total hospital charges, rate of Sepsis, Septic Shock, and ARF in comparison to patients without Obesity; however, non-obese patients had higher odds of developing AKI throughout hospitalization. Conclusion: Although it is known and described that being obese plays a significant role in the onset of diabetes, and consequently HHS, there is no statistically significant difference in mortality or most other adverse outcomes compared to patients that are not obese and develop HHS. Although being obese plays a major role in inciting HHS in the general population, there is no need for a different approach to treatment, and outcomes are similar to non-obese patients with HHS.

Abstract 15296: Systemic Lupus Erythematosus Patients Admitted for Atrial Fibrillation Do Not Have Worse Outcomes: Analysis of the National Inpatient Sample

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ehizogie Edigin ◽  
precious O Eseaton ◽  
Mavi M Rivera Pavon ◽  
Emmanuel Akuna ◽  
Iriagbonse R Asemota ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Lupus Erythematosus ◽  
Electrical Cardioversion ◽  
Hospital Charges ◽  
Secondary Diagnosis ◽  
National Inpatient Sample ◽  
Inpatient Mortality ◽  
Systemic Lupus ◽  
Total Hospital ◽  
Icd 10

Introduction: Systemic Lupus Erythematosus (SLE) is known to increase the risk of atrial fibrillation (AF), however it is unclear if SLE worsens outcomes in patients admitted for AF. This study aims to compare the outcomes of patients primarily admitted for AF with and without a secondary diagnosis of SLE. Methods: Data were abstracted from the National Inpatient Sample (NIS) 2016 and 2017 Database. NIS is the largest inpatient hospitalization database in the United States. The NIS was searched for hospitalizations with AF as principal diagnosis with and without SLE as secondary diagnosis using ICD-10 codes. Hospitalizations for adult patients from the above groups were identified. The primary outcome was inpatient mortality. Hospital length of stay (LOS), total hospital charges, odds of undergoing ablation, pharmacologic, and electrical cardioversion were secondary outcomes of interest. Multivariate logistic and linear regression analysis was used accordingly to adjust for confounders. STATA software was used to analyze the data. Results: There were over 71 million discharges included in the combined 2016 and 2017 NIS database. 821,630 hospitalizations were for adult patients, who had a principal ICD-10 code for AF. 2,645 (0.3%) of these hospitalizations have co-existing SLE. SLE group were younger (67 vs 71 years, P < 0.0001) and had more females (85% vs 51%, P < 0.0001). Hospitalizations for AF with SLE had similar inpatient mortality (1.5% vs 0.91%, AOR: 1.0, 95% CI 0.47-2.14, P=0.991), LOS ( 4.2 vs 3.4 days, P=0.525), total hospital charges ( $51,351vs $39,121, P=0.056), odds of undergoing pharmacologic cardioversion ( 0.38% vs 0.38%, AOR: 0.90, 95% CI 0.22-3.69, P=0.880) and electrical cardioversion (12.9% vs 17.5%, AOR 0.87, 95% CI 0.66-1.15, P=0.324) compared to those without SLE. Hospitalizations for AF with SLE had increased odds of undergoing ablation (6.8% vs 4.2%, AOR: 1.9, 95% CI 1.3-2.7, P<0.0001) compared to those without SLE. Conclusions: Patients admitted primarily for AF with co-existing SLE had similar inpatient mortality, LOS, total hospital charges, likelihood of undergoing pharmacologic and electrical cardioversion compared to those without SLE. However, SLE group had more odds of undergoing ablation.

Abstract 15308: Psoriasis Does Not Worsen Outcomes of Patients Admitted for Atrial Fibrillation: Analysis of the National Inpatient Sample

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ehizogie Edigin ◽  
precious O Eseaton ◽  
Iriagbonse R Asemota ◽  
Emmanuel Akuna ◽  
Hafeez Shaka ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Linear Regression Analysis ◽  
The United States ◽  
Electrical Cardioversion ◽  
Hospital Length Of Stay ◽  
Hospital Charges ◽  
Secondary Diagnosis ◽  
National Inpatient Sample ◽  
Inpatient Mortality ◽  
Total Hospital

Introduction: Studies have shown that psoriasis increases the risk of atrial fibrillation (AF). However, it is unclear if co-existing psoriasis worsens outcomes in AF hospitalizations. This study aims to compare the outcomes of patients primarily admitted for AF with and without a secondary diagnosis of psoriasis. Methods: Data were abstracted from the National Inpatient Sample (NIS) 2016 and 2017 Database. NIS is the largest inpatient hospitalization database in the United States. The NIS was searched for hospitalizations for adult patients with AF as principal diagnosis with and without psoriasis as secondary diagnosis using ICD 10 codes. The primary outcome was inpatient mortality. Hospital length of stay (LOS), total hospital charges, odds of undergoing ablation, pharmacological, and electrical cardioversion were secondary outcomes of interest. Multivariate logistic and linear regression analysis was used accordingly to adjust for confounders. STATA software was used to analyze the data. Results: There were over 71 million hospitalizations in the combined NIS 2016 and 2017 database. Out of 821,630 hospitalizations for AF, 4,490 (0.55%) had Psoriasis. Hospitalizations for AF with psoriasis had similar inpatient mortality [0.78% vs 0.92%, AOR 0.95, 95% CI (0.44-2.04), P=0.895], total hospital charge [$41,869 vs $39,145, P=0.572] and longer LOS [3.72 vs 3.37 days, P=0.023] compared to those without psoriasis. Odds of undergoing ablation [5.0% vs 4.2%, AOR 1.12, 95% CI (0.82-1.52), P=0.481], pharmacologic cardioversion [0.11% vs 0.38%, AOR 0.29, 95% CI (0.04-2.10), P=0.219] and electrical cardioversion [19.2% vs 17.5%, AOR 0.99, 95% CI (0.83-1.19), P=0.930] were similar in both groups. Conclusion: Hospitalizations for AF with psoriasis had longer LOS compared to those without psoriasis. AF hospitalizations with psoriasis however had similar inpatient mortality, total hospital charges, odds of undergoing ablation, pharmacologic and electrical cardioversion compared to those without psoriasis.

scholarly journals Path Analysis of the Impact of Obesity on Postoperative Outcomes in Colorectal Cancer Patients: A Population-Based Study

2021 ◽  
Vol 10 (13) ◽  
pp. 2904
Author(s):  
Kuan-Chih Chung ◽  
Ko-Chao Lee ◽  
Hong-Hwa Chen ◽  
Kung-Chuan Cheng ◽  
Kuen-Lin Wu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Path Analysis ◽  
Postoperative Infection ◽  
Digestive System ◽  
Length Of Hospital Stay ◽  
Hospital Charges ◽  
Perioperative Outcomes ◽  
Total Hospital

Background: Obesity is adversely affecting perioperative outcomes; however, long-term outcomes do not appear to be affected by excess body weight (the obesity paradox). The purpose of this study is to examine the association between obesity and surgical outcomes in patients with colorectal cancer (CRC) using data from the United States National Inpatient Sample (NIS). Methods: Patients ≥20 years old diagnosed with CRC who received surgery were identified in the 2004–2014 NIS database. Patients who were obese (ICD-9-CM code: 278.0) were matched with controls (non-obese) in a 1:4 ratio for age, sex, and severity of CRC (metastasis vs. no metastasis). Linear regression and path analysis were used to compare outcomes between obese and non-obese patients. A total of 107,067 patients (53,376 males, 53,691 females) were included in the analysis, and 7.86% were obese. Results: The rates of postoperative infection, shock, bleeding, wound disruption, and digestive system complications were significantly different between the obese and non-obese groups. The obesity group had increased incidence of postoperative infection by 1.9% (∂P/∂X = 0.019), shock by 0.25% (∂P/∂X = 0.0025), postoperative bleeding by 0.5% (∂P/∂X = 0.005), wound disruption by 0.6% (∂P/∂X = 0.006), and digestive system complications by 1.35% (∂P/∂X = 0.0135). Path analysis showed that obesity group had higher in-hospital mortality through mentioned above five complications by 66.65 × 10−5%, length of hospital stay by 0.32 days, and total hospital charges by 2384 US dollars. Conclusions: Obesity increases the risk of postoperative complications in patients with CRC undergoing surgery. It also increased in-hospital mortality, length of hospital stay, and total hospital charges. Therefore, patients with obesity might require a higher level of preoperative interventions and complications monitoring to improve outcomes.

scholarly journals Diabetes Does Not Worsen Outcomes of Patients Admitted for Hyperthyroidism: Analysis of the National Inpatient Sample

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A410-A410
Author(s):  
Hafeez Shaka ◽  
Emmanuel Akuna ◽  
Dimeji Olukunmi Williams ◽  
Iriagbonse Asemota ◽  
Ehizogie Edigin ◽  
...  
Keyword(s):  
Linear Regression Analysis ◽  
The United States ◽  
Hospital Charge ◽  
Hospital Length Of Stay ◽  
Hospital Charges ◽  
Secondary Diagnosis ◽  
National Inpatient Sample ◽  
Inpatient Mortality ◽  
Total Hospital ◽  
Total Hospital Charge

Abstract Introduction: Both diabetes mellitus (DM) and hyperthyroidism are common diseases. However, it is unclear if co-existing DM worsens outcomes in patients with hyperthyroidism. This study aims to compare the outcomes of patients primarily admitted for hyperthyroidism with and without a secondary diagnosis of DM. Methods: Data were extracted from the National Inpatient Sample (NIS) 2016 and 2017 Database. NIS is the largest inpatient hospitalization database in the United States. The NIS was searched for hospitalizations for adult patients with hyperthyroidism as principal diagnosis with and without DM as secondary diagnosis using ICD 10 codes. The primary outcome was inpatient mortality. Hospital length of stay (LOS), total hospital charges and NSTEMI were secondary outcomes of interest. Multivariate logistic and linear regression analysis was used accordingly to adjust for confounders. Results: There were over 71 million hospitalizations in the combined NIS 2016 and 2017 database. Out of 17,705 hospitalizations for hyperthyroidism, 2,160 (15.9%) had DM. Hospitalizations for hyperthyroidism with DM had similar inpatient mortality [0.35% vs 0.50%, AOR 0.25, 95% CI (0.05–1.30), P= 0.101], total hospital charge [$47,001 vs $36,978 P=0.220], LOS [4.50 vs 3.48 days, P=0.050] and NSTEMI compared to those without DM. Conclusion: Hospitalizations for hyperthyroidism with DM had similar inpatient mortality, total hospital charges, LOS and odds of undergoing ablation compared to those without obesity.

Outcomes of atrial fibrillation hospitalizations in patients with systemic lupus erythematosus: a report from the national inpatient sample

2021 ◽  
pp. jim-2020-001707
Author(s):  
Mavi Maureen Rivera Pavon ◽  
Anoj Shahi ◽  
Emmanuel Akuna ◽  
Iriagbonse Rotimi Asemota ◽  
Abdul Wahab Arif ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Lupus Erythematosus ◽  
Electrical Cardioversion ◽  
Hospital Charges ◽  
Secondary Diagnosis ◽  
National Inpatient Sample ◽  
Inpatient Mortality ◽  
Principal Diagnosis ◽  
Systemic Lupus ◽  
Total Hospital

This study compares outcomes of patients admitted for atrial fibrillation (AF) with and without coexisting systemic lupus erythematosus (SLE). The primary outcome was inpatient mortality. Hospital length of stay (LOS), total hospital charges, odds of undergoing ablation, pharmacologic cardioversion and electrical cardioversion were secondary outcomes of interest. Data were abstracted from the National Inpatient Sample (NIS) 2016 and 2017 database. The NIS was searched for adult hospitalizations with AF as principal diagnosis with and without SLE as secondary diagnosis using International Classification of Diseases, Tenth Revision, Clinical Modification codes. Multivariate logistic and linear regression analysis was used accordingly to adjust for confounders. There were over 71 million discharges included in the combined 2016 and 2017 NIS database. 821,630 hospitalizations were for adult patients, who had a principal diagnosis of AF, out of which, 2645 (0.3%) had SLE as secondary diagnosis. Hospitalizations for AF with SLE had similar inpatient mortality (1.5% vs 0.91%, adjusted OR (AOR): 1.0, 95% CI 0.47 to 2.14, p=0.991), LOS (4.2 vs 3.4 days, p=0.525), total hospital charges ($51,351 vs $39,121, p=0.056), odds of undergoing pharmacologic cardioversion (0.38% vs 0.38%, AOR: 0.90, 95% CI 0.22 to 3.69, p=0.880) and electrical cardioversion (12.9% vs 17.5%, AOR 0.87, 95% CI 0.66 to 1.15, p=0.324) compared with those without SLE. However, SLE group had increased odds of undergoing ablation (6.8% vs 4.2%, AOR: 1.9, 95% CI 1.3 to 2.7, p<0.0001). Patients admitted for AF with SLE had similar inpatient mortality, LOS, total hospital charges, likelihood of undergoing pharmacologic and electrical cardioversion compared with those without SLE. However, SLE group had greater odds of undergoing ablation.

scholarly journals Atrial Fibrillation Does Not Negatively Impact the Outcomes of Patients Admitted for Hyperthyroidism: Analysis of the National Inpatient Sample

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A973-A974
Author(s):  
Emmanuel Akuna ◽  
Iriagbonse Asemota ◽  
Hafeez Shaka ◽  
Ehizogie Edigin ◽  
Genaro Velazquez ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Cerebrovascular Accident ◽  
Hospital Charges ◽  
Secondary Diagnosis ◽  
National Inpatient Sample ◽  
Inpatient Mortality ◽  
Total Hospital ◽  
Icd 10

Abstract Introduction: Hyperthyroidism is a well-known risk factor for the development of atrial fibrillation(AF), but the outcomes hyperthyroidism in patients with atrial fibrillation is unclear. This study aims to compare the outcomes of patients primarily admitted for hyperthyroidism with and without a secondary diagnosis of AF. Methods: Data were abstracted from the National Inpatient Sample (NIS) 2016 and 2017 Database. NIS is the largest inpatient hospitalization database in the United States. The NIS was searched for hospitalizations with a principal diagnosis of hyperthyroidism with and without AF as secondary diagnosis using ICD-10 codes. Hospitalizations for adult patients (age≥ 18 years) from the above groups were identified. The primary outcome was inpatient mortality. Hospital length of stay (LOS), total hospital charges, cerebrovascular accident and acute respiratory failure were secondary outcomes of interest. Multivariate logistic and linear regression analysis was used accordingly to adjust for confounders. Results: There were over 71 million discharges included in the combined 2016 and 2017 NIS database. 17,705 hospitalizations were for adult patients who had a principal ICD-10 code for hyperthyroidism. 4,165 (23%) of these hospitalizations had co-existing AF. AF group were older (57 vs 44 years, P &lt; 0.0001) and had less females (65% vs 78%, P &lt; 0.0001). Hospitalizations for Hyperthyroidism with AF had similar inpatient mortality (0.96% vs 0.33%, AOR: 1.7, 95% CI 0.58-5.14, P=0.324) with longer LOS (5.1 vs 3.2 days, P=0.000), increased total hospital charges ($51,904 vs $34,471, P=0.002), increased odds of cerebrovascular accident (0.8% vs 0.1%, AOR: 5.01, 95% CI 1.1-22.2, P&lt;0.034) and increased odds of acute respiratory failure(4.4% vs 1.3%, AOR: 3.01, 95% CI 1.8-5.0, P&lt;0.000) compared to those without AF. Conclusions: Patients admitted primarily for hyperthyroidism with co-existing AF had similar inpatient mortality but with longer LOS, increased total hospital charges, increased likelihood of having cerebrovascular accident and acute respiratory failure when compared to those without AF.

scholarly journals Lung involvement in systemic sclerosis is associated with adverse hospital outcomes: insights from the National Inpatient Sample

2021 ◽  
pp. jim-2020-001743
Author(s):  
Jesse Osemudiamen Odion ◽  
Armaan Guraya ◽  
Chukwudi Charles Modijeje ◽  
Osahon Nekpen Idolor ◽  
Eseosa Jennifer Sanwo ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Hospital Charge ◽  
Hospital Length Of Stay ◽  
Lung Involvement ◽  
National Inpatient Sample ◽  
Inpatient Mortality ◽  
Total Hospital ◽  
Total Hospital Charge ◽  
Icd 10 ◽  
Secondary Outcomes

This study aimed to compare outcomes of systemic sclerosis (SSc) hospitalizations with and without lung involvement. The primary outcome was inpatient mortality while secondary outcomes were hospital length of stay (LOS) and total hospital charge. Data were abstracted from the National Inpatient Sample (NIS) 2016 and 2017 database. This database is the largest collection of inpatient hospitalization data in the USA. The NIS was searched for SSc hospitalizations with and without lung involvement as principal or secondary diagnosis using International Classification of Diseases 10th Revision (ICD-10) codes. SSc hospitalizations for patients aged ≥18 years from the above groups were identified. Multivariate logistic and linear regression analysis was used to adjust for possible confounders for the primary and secondary outcomes, respectively. There were over 71 million discharges included in the combined 2016 and 2017 NIS database. 62,930 hospitalizations were for adult patients who had either a principal or secondary ICD-10 code for SSc. 5095 (8.10%) of these hospitalizations had lung involvement. Lung involvement group had greater inpatient mortality (9.04% vs 4.36%, adjusted OR 2.09, 95% CI 1.61 to 2.73, p<0.0001), increase in mean adjusted LOS of 1.81 days (95% CI 0.98 to 2.64, p<0.0001), and increase in mean adjusted total hospital charge of $31,807 (95% CI 14,779 to 48,834, p<0.0001), compared with those without lung involvement. Hospitalizations for SSc with lung involvement have increased inpatient mortality, LOS and total hospital charge compared with those without lung involvement. Collaboration between the pulmonologist and the rheumatologist is important in optimizing outcomes of SSc hospitalizations with lung involvement.

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