scholarly journals Respiratory complications and 30-day unplanned hospital readmissions in patients with epilepsy

2019 ◽  
Vol 9 (5) ◽  
pp. 408-416
Author(s):  
Radhika Parikh ◽  
Romil Parikh ◽  
Smit Patel ◽  
Ninad Desai ◽  
Tapan Mehta ◽  
...  
Keyword(s):  
Health Care ◽  
Status Epilepticus ◽  
Demographic Data ◽  
Hospital Readmissions ◽  
International Classification Of Diseases ◽  
Discharge Diagnosis ◽  
Respiratory Complications ◽  
Us Economy ◽  
Classification Of Diseases ◽  
Patients With Epilepsy

BackgroundTo help mitigate the burden of health care on US economy, public policymakers and health care legislation have been focusing on reducing hospital readmissions. Respiratory complications have been identified among the commonest of adverse events in neurologic patients. The goal of our study was to better understand respiratory complications and their contribution to rehospitalizations in patients with seizures.MethodsWe used the 2013 Nationwide Readmission Database to analyze unplanned 30-day readmission rate (30RR). The study population comprised of patients with index hospital discharge diagnosis of generalized convulsive epilepsy and status epilepticus. Patients under 18 years of age, who died during hospitalization or who had missing demographic data, were excluded. Patients hospitalized in December were also excluded due to lack of 30-day follow-up. The primary outcome of interest was 30-day readmission. The causes of readmission were determined by corresponding International Classification of Diseases, Ninth Revision, Clinical Modification codes.ResultsThe 30RR was highest in patients with index hospitalization discharge diagnosis of status epilepticus, followed by generalized convulsive epilepsy (intractable), followed by generalized convulsive epilepsy (nonintractable). While seizure was the most common reason for readmission, contribution of respiratory complications to readmissions was 7.85%, 12.39%, and 6.93%, respectively. Pneumonia/aspiration pneumonitis and respiratory insufficiency accounted for the majority of the readmissions in all subgroups.ConclusionsRespiratory complications are the leading nonseizure cause of 30-day unplanned readmissions in patients with generalized convulsive epilepsy and status epilepticus. Further research on identifying appropriate interventions to reduce readmissions from respiratory causes may improve outcomes for patients in these epilepsy subgroups.

Impact of ICD-9 to ICD-10 Coding Transition on Prevalence Trends in Neurology

2021 ◽  
Vol 11 (5) ◽  
pp. e612-e619
Author(s):  
Ali G. Hamedani ◽  
Leah Blank ◽  
Dylan P. Thibault ◽  
Allison W. Willis
Keyword(s):  
Time Series ◽  
Status Epilepticus ◽  
Interrupted Time Series ◽  
International Classification Of Diseases ◽  
Disease Prevalence ◽  
Rate Of Change ◽  
International Classification ◽  
Classification Of Diseases ◽  
Icd 10

ObjectiveTo determine the effect of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) to International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) coding transition on the point prevalence and longitudinal trends of 16 neurologic diagnoses.MethodsWe used 2014–2017 data from the National Inpatient Sample to identify hospitalizations with one of 16 common neurologic diagnoses. We used published ICD-9-CM codes to identify hospitalizations from January 1, 2014, to September 30, 2015, and used the Agency for Healthcare Research and Quality's MapIt tool to convert them to equivalent ICD-10-CM codes for October 1, 2015–December 31, 2017. We compared the prevalence of each diagnosis before vs after the ICD coding transition using logistic regression and used interrupted time series regression to model the longitudinal change in disease prevalence across time.ResultsThe average monthly prevalence of subarachnoid hemorrhage was stable before the coding transition (average monthly increase of 4.32 admissions, 99.7% confidence interval [CI]: −8.38 to 17.01) but increased after the coding transition (average monthly increase of 24.32 admissions, 99.7% CI: 15.71–32.93). Otherwise, there were no significant differences in the longitudinal rate of change in disease prevalence over time between ICD-9-CM and ICD-10-CM. Six of 16 neurologic diagnoses (37.5%) experienced significant changes in cross-sectional prevalence during the coding transition, most notably for status epilepticus (odds ratio 0.30, 99.7% CI: 0.26–0.34).ConclusionsThe transition from ICD-9-CM to ICD-10-CM coding affects prevalence estimates for status epilepticus and other neurologic disorders, a potential source of bias for future longitudinal neurologic studies. Studies should limit to 1 coding system or use interrupted time series models to adjust for changes in coding patterns until new neurology-specific ICD-9 to ICD-10 conversion maps can be developed.

scholarly journals Readmissions After Complex Cancer Surgery: Analysis of the Nationwide Readmissions Database

2018 ◽  
Vol 14 (6) ◽  
pp. e335-e345 ◽  
Author(s):  
Syed Nabeel Zafar ◽  
Adil A. Shah ◽  
Christine Nembhard ◽  
Lori L. Wilson ◽  
Elizabeth B. Habermann ◽  
...  
Keyword(s):  
Private Insurance ◽  
Lung Resection ◽  
Hospital Readmissions ◽  
International Classification Of Diseases ◽  
Primary Diagnosis ◽  
Cancer Surgery ◽  
Prolonged Length ◽  
Factors Associated ◽  
Diagnosis Codes ◽  
Classification Of Diseases

Purpose: Hospital readmissions after surgery are a focus of quality improvement efforts. Although some reflect appropriate care, others are potentially preventable readmissions (PPRs). We aim to describe the burden, timing, and factors associated with readmissions after complex cancer surgery. Methods: The Nationwide Readmissions Database (2013) was used to select patients undergoing a complex oncologic resection, which was defined as esophagectomy/gastrectomy, hepatectomy, pancreatectomy, colorectal resection, lung resection, or cystectomy. Readmissions within 30 days from discharge were analyzed. International Classification of Diseases (9th revision) primary diagnosis codes were reviewed to identify PPRs. Multivariable logistic regression analyses identified demographic, clinical, and hospital factors associated with readmissions. Results: Of the 59,493 eligible patients, 14% experienced a 30-day readmission, and 82% of these were deemed PPRs. Half of the readmissions occurred within the first 8 days of discharge. Infections (26%), GI complications (17%), and respiratory conditions (10%) accounted for most readmissions. Factors independently associated with an increased likelihood of readmission included Medicaid versus private insurance (odds ratio [OR], 1.32; 95% CI, 1.17 to 1.48), higher comorbidity score (OR, 1.5; 95% CI, 1.33 to 1.63), discharge to a facility (OR, 1.39; 95% CI, 1.29 to 1.51), prolonged length of stay (OR, 1.42; 95% CI, 1.32 to 1.52), and occurrence of a major in-hospital complication (OR, 1.24; 95% CI, 1.16 to 1.34). Conclusion: One in seven patients undergoing complex cancer surgery suffered a readmission within 30 days. We identified common causes of these and identified patients at high risk for such an event. These data can be used by physicians, administrators, and policymakers to develop strategies to decrease readmissions.

scholarly journals The cost of health care in Serbia according to the international classification of diseases for the period from 2004 to 2009

2011 ◽  
Vol 58 (3) ◽  
pp. 127-138 ◽  
Author(s):  
Milena Gajic-Stevanovic ◽  
Snezana Dimitrijevic ◽  
Slavoljub Zivkovic ◽  
Nevenka Teodorovic ◽  
Darinka Perisic-Rajnicke
Keyword(s):  
Health Care ◽  
Comparative Analysis ◽  
International Classification Of Diseases ◽  
Financial Information ◽  
Cost Of Health Care ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
The Cost ◽  
Circulatory Diseases

Introduction. As the part of research on costs in the health care system, there is a growing interest in the world for the estimating costs for the treatment of disease. This value represents the burden that a particular disease or group of diseases puts on the society. Until the year 2000, when the Organization for Economic Countries Development (OECD) established a System of Health Accounts (SHA), there was not even approximate methodological guide for calculating the cost of the disease. The aim of this study was to determine the costs of health care in the Republic of Serbia according to the major International Classification of Diseases (ICD-10) and to provide a comparative cost analysis for the treatment of diseases in the period from 2004 to 2009. Material and Methods. A retrospective and comparative analysis of health statistics from the database of the Institute of Public Health of Serbia and financial information provided by the Health Insurance Fund in the period 2004-2009 was performed. Financial information and data on hospital services, outpatient, home health care, ancillary health care services, drug consumption and consumer goods in healthcare were analyzed using SHA methodology. Results. Results showed that during the observation period, the maximum cost of health care in Serbia by main classification of ICD-10 was achieved in 2009 and it was RSD 144,150,456,906.00 (? 1,503,321,134; $ 2,160,253,219) and the minimal cost was achieved in 2004 - the amount being RSD 49,546,211,470.00 (? 628,086,723; $ 855,203,134). Results showed that in 2004 the highest costs were allocated to circulatory diseases (18.98%), followed by neoplasm (11.12%), and lowest for congenital anomalies (0.64%). In 2009, the highest costs were allocated to circulatory diseases (18.87%), infectious and parasitic diseases (11.20%), diseases of digestive system (9.26%) nervous system diseases (9.20%), and neoplasm (8.88%), whereas the minimal funds were allocated for congenital anomalies (0.33%). Conclusion. Comparative analysis showed that the value of overall spending in healthcare increased three times in 2009 as compared to 2004.

scholarly journals Long-Term Study about the Incidence of Epilepsy in Male Service Personnel from India: A Retrospective, Cohort Study

2019 ◽  
Vol 10 (04) ◽  
pp. 588-591
Author(s):  
Pawan Dhull ◽  
S. K. Patnaik ◽  
Manoj Somasekharan ◽  
K. V. S Hari Kumar
Keyword(s):  
Incidence Rate ◽  
Good Health ◽  
International Classification Of Diseases ◽  
Service Personnel ◽  
Long Term Study ◽  
Active Service ◽  
Classification Of Diseases ◽  
Alcohol Dependence Syndrome ◽  
Patients With Epilepsy

Abstract Background The data on the epidemiology of epilepsy are limited for developing countries including India. We estimated the incidence of epilepsy in a cohort of service personnel from India followed for over two decades. Materials and Methods The data for this epidemiological study were derived from the electronic medical records (EMRs) of the male service personnel. The participants (age < 18 years) were enrolled into active service between 1990 and 2015 in good health. The data pertaining to the diagnosis of epilepsy were derived from the EMR using the prevalent International Classification of Diseases codes. We calculated the incidence rate as per person-years (py) using appropriate statistical methods. Results Our data included 51,217 participants (median age: 33 years, range: 17–54) with a mean follow-up of 12.5 years, giving a cumulative follow-up duration of 613,925 py. A total of 291 patients developed epilepsy during the study, giving an incidence rate of 0.47 per 1000 py (95% confidence interval: 0.42–0.53). Undifferentiated spondyloarthropathy, central nervous system disorders, and alcohol dependence syndrome were the common comorbid ailments in patients with epilepsy. Conclusion Our cohort had a comparable incidence rate of epilepsy with other studies from India and abroad.

scholarly journals The Role of COVID-19 in the Death of SARS-CoV-2–Positive Patients: A Study Based on Death Certificates

2020 ◽  
Vol 9 (11) ◽  
pp. 3459 ◽  
Author(s):  
Francesco Grippo ◽  
Simone Navarra ◽  
Chiara Orsi ◽  
Valerio Manno ◽  
Enrico Grande ◽  
...  
Keyword(s):  
Heart Disease ◽  
Cause Of Death ◽  
Hypertensive Heart Disease ◽  
International Classification Of Diseases ◽  
Death Certificates ◽  
Respiratory Complications ◽  
Classification Of Diseases ◽  
Underlying Cause Of Death ◽  
And Gender ◽  
Low Prevalence

Background: Death certificates are considered the most reliable source of information to compare cause-specific mortality across countries. The aim of the present study was to examine death certificates of persons who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to (a) quantify the number of deaths directly caused by coronavirus 2019 (COVID-19); (b) estimate the most common complications leading to death; and (c) identify the most common comorbidities. Methods: Death certificates of persons who tested positive for SARS-CoV-2 provided to the National Surveillance system were coded according to the 10th edition of the International Classification of Diseases. Deaths due to COVID-19 were defined as those in which COVID-19 was the underlying cause of death. Complications were defined as those conditions reported as originating from COVID-19, and comorbidities were conditions independent of COVID-19. Results: A total of 5311 death certificates of persons dying in March through May 2020 were analysed (16.7% of total deaths). COVID-19 was the underlying cause of death in 88% of cases. Pneumonia and respiratory failure were the most common complications, being identified in 78% and 54% of certificates, respectively. Other complications, including shock, respiratory distress and pulmonary oedema, and heart complications demonstrated a low prevalence, but they were more commonly observed in the 30–59 years age group. Comorbidities were reported in 72% of certificates, with little variation by age and gender. The most common comorbidities were hypertensive heart disease, diabetes, ischaemic heart disease, and neoplasms. Neoplasms and obesity were the main comorbidities among younger people. Discussion: In most persons dying after testing positive for SARS-CoV-2, COVID-19 was the cause directly leading to death. In a large proportion of death certificates, no comorbidities were reported, suggesting that this condition can be fatal in healthy persons. Respiratory complications were common, but non-respiratory complications were also observed.

scholarly journals Acute Infectious Morbidity in Multiple Gestation

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Sarah K. Dotters-Katz ◽  
Emily Patel ◽  
Chad A. Grotegut ◽  
R. Phillips Heine
Keyword(s):  
Demographic Data ◽  
Mode Of Delivery ◽  
International Classification Of Diseases ◽  
Infectious Complications ◽  
Multiple Gestation ◽  
Susceptibility To Infection ◽  
Infectious Morbidity ◽  
Intestinal Infections ◽  
Increased Risk ◽  
Classification Of Diseases

Objectives. Physiologic and immunologic changes in pregnancy result in increased susceptibility to infection. These shifts are more pronounced in pregnancies complicated by multiple gestation. The objective of this study was to determine the association between multiple gestation and risk of infectious morbidity.Study Design. The Nationwide Inpatient Sample for the years 2008–2010 was used to identify pregnant women during admission for delivery with International Classification of Diseases codes. Logistic regression was used to compute odds ratios and 95% confidence intervals for demographic data, preexisting medical conditions, and acute medical and infectious complications for women with multiple versus singleton gestations.Results. Among women with multiple gestation, 38.4 per 1,000 women had an infectious complication compared to 12.8 per 1,000 women with singletons. The most significant infectious morbidity associated with multiple gestation was intestinal infections, pyelonephritis, influenza, and pneumonia. After controlling for confounding variables, infectious complications at delivery persisted for women with multiples, though the association was dependent on mode of delivery.Conclusions. Women with multiple gestations are at increased risk for infectious morbidity identified at the time of delivery. This association was diminished among women who had a cesarean suggesting that operative delivery is not responsible for this association.

scholarly journals Validity of the International Classification of Diseases, 10th revision discharge diagnosis codes for hyponatraemia in the Danish National Registry of Patients

BMJ Open ◽  
2014 ◽  
Vol 4 (4) ◽  
pp. e004956 ◽  
Author(s):  
Louise Holland-Bill ◽  
Christian Fynbo Christiansen ◽  
Sinna Pilgaard Ulrichsen ◽  
Troels Ring ◽  
Jens Otto Lunde Jørgensen ◽  
...  
Keyword(s):  
International Classification Of Diseases ◽  
National Registry ◽  
International Classification ◽  
Discharge Diagnosis ◽  
Diagnosis Codes ◽  
Classification Of Diseases

scholarly journals An Assessment of Frequency of Dermatologic Diseases in Patients Admitted to Shiraz Referral Dermatology Ward, Southern Iran 2008-2011

2015 ◽  
Vol 4 (1) ◽  
pp. 50-52
Author(s):  
Ladan Dastgheib ◽  
Nasrin Saki ◽  
Sina Kardeh ◽  
Zakaria Rezaei
Keyword(s):  
Skin Diseases ◽  
Average Length ◽  
Demographic Data ◽  
International Classification Of Diseases ◽  
Occurrence Rate ◽  
Fars Province ◽  
Duration Of Treatment ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Drug Rash

Background: As the early and accurate diagnosis of all diseases, including skin disorders directly influences the duration of treatment and its costs, which may be a significant burden, it is very important for physicians to be familiar with all types of diseases, especially those with a higher incidence in population. Considering that disease patterns vary from region to region and there is no demographic data on patterns of skin diseases in Fars Province, we aimed to assess the frequency of skin diseases in admitted patients to Dermatology Ward of Shahid Faghihi Hospital. Materials and Methods: The medical records of 1450 patients, who completed a questionnaire during the years 2008 to 2011, were evaluated in this retrospective study. Demographic data and diagnoses of skin diseases were analyzed by SPSS software and classified according to the International Classification of Diseases (ICD-10).Results: Pemphigus (12.5%), drug rash (11.7%) and eczema (10.5%) were the most common cause of referral to dermatology ward. The mean age of patients was 41.89±20.79 and the average length of hospitalization in this study was 9.34 days.Conclusion: The high occurrence rate of Pemphigus and drug rash indicates that further study is required to root out the underlying causes. Proper health policies should be implemented to manage these diseases.

A novel approach of privacy-preserving data sharing system through data-tagging with role-based access control

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Tanvi Garg ◽  
Navid Kagalwalla ◽  
Shubha Puthran ◽  
Prathamesh Churi ◽  
Ambika Pawar
Keyword(s):  
Health Care ◽  
Access Control ◽  
International Classification Of Diseases ◽  
Role Based Access Control ◽  
Content Type ◽  
Health Care Data ◽  
Novel Approach ◽  
Classification Of Diseases ◽  
Role Based ◽  
Access Policies

Purpose This paper aims to design a secure and seamless system that ensures quick sharing of health-care data to improve the privacy of sensitive health-care data, the efficiency of health-care infrastructure, effective treatment given to patients and encourage the development of new health-care technologies by researchers. These objectives are achieved through the proposed system, a “privacy-aware data tagging system using role-based access control for health-care data.” Design/methodology/approach Health-care data must be stored and shared in such a manner that the privacy of the patient is maintained. The method proposed, uses data tags to classify health-care data into various color codes which signify the sensitivity of data. It makes use of the ARX tool to anonymize raw health-care data and uses role-based access control as a means of ensuring only authenticated persons can access the data. Findings The system integrates the tagging and anonymizing of health-care data coupled with robust access control policies into one architecture. The paper discusses the proposed architecture, describes the algorithm used to tag health-care data, analyzes the metrics of the anonymized data against various attacks and devises a mathematical model for role-based access control. Originality/value The paper integrates three disparate topics – data tagging, anonymization and role-based access policies into one seamless architecture. Codifying health-care data into different tags based on International Classification of Diseases 10th Revision (ICD-10) codes and applying varying levels of anonymization for each data tag along with role-based access policies is unique to the system and also ensures the usability of data for research.

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