scholarly journals Identification of Medicare Recipients at Highest Risk for Clostridium difficile Infection in the US by Population Attributable Risk Analysis

PLoS ONE ◽  
2016 ◽  
Vol 11 (2) ◽  
pp. e0146822 ◽  
Author(s):  
Erik R. Dubberke ◽  
Margaret A. Olsen ◽  
Dustin Stwalley ◽  
Ciarán P. Kelly ◽  
Dale N. Gerding ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Risk Analysis ◽  
Clostridium Difficile Infection ◽  
Population Attributable Risk ◽  
Attributable Risk ◽  
The Us

scholarly journals Reduced Mortality Associated with Acute Kidney Injury Requiring Dialysis in the United States

2016 ◽  
Vol 43 (4) ◽  
pp. 261-270 ◽  
Author(s):  
Jeremiah R. Brown ◽  
Michael E. Rezaee ◽  
William M. Hisey ◽  
Kevin C. Cox ◽  
Michael E. Matheny ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Hospital Mortality ◽  
Incidence Rate ◽  
Hospital Admissions ◽  
Population Attributable Risk ◽  
Kidney Injury ◽  
The United States ◽  
Attributable Risk ◽  
Discharge Data ◽  
The Us

Background: Dialysis-requiring acute kidney injury (AKI-D) is a documented complication of hospitalization and procedures. Temporal incidence of AKI-D and related hospital mortality in the US population has not been recently characterized. We describe the epidemiology of AKI-D as well as associated in-hospital mortality in the US. Methods: Retrospective cohort of a national discharge data (n = 86,949,550) from the Healthcare Cost and Utilization Project's National Inpatient Sample, 2001-2011 of patients' hospitalization with AKI-D. Primary outcomes were AKI-D and in-hospital mortality. We determined the annual incidence rate of AKI-D in the US from 2001 to 2011. We estimated ORs for AKI-D and in-hospital mortality for each successive year compared to 2001 using multiple logistic regression models, adjusted for patient and hospital characteristics, and stratified the analyses by sex and age. We also calculated population-attributable risk of in-hospital mortality associated with AKI-D. Results: The adjusted odds of AKI-D increased by a factor of 1.03 (95% CI 1.02-1.04) each year. The number of AKI-D-related (19,886-34,195) in-hospital deaths increased almost 2-fold, although in-hospital mortality associated with AKI-D (28.0-19.7%) declined significantly from 2001 to 2011. Over the same period, the adjusted odds of mortality for AKI-D patients were 0.60 (95% CI 0.56-0.67). Population-attributable risk of mortality associated with AKI-D increased (2.1-4.2%) over the study period. Conclusions: The incidence rate of AKI-D has increased considerably in the US since 2001. However, in-hospital mortality associated with AKI-D hospital admissions has decreased significantly.

scholarly journals Outbreak of Clostridium difficile infection in an English hospital linked to hypertoxin-producing strains in Canada and the US

2005 ◽  
Vol 10 (26) ◽  
Author(s):  
Alyson Smith
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Acute Hospital ◽  
The Us

An outbreak of Clostridium difficile infections in an acute hospital in southeast England is currently being investigated.

scholarly journals Increasing Economic Burden of Inpatient Clostridium difficile Infection in the United States: National Trends in Epidemiology, Outcomes, and Cost of Care from 2000 to 2014

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S392-S392 ◽  
Author(s):  
Ru Min Lee ◽  
Neil O Fishman
Keyword(s):  
United States ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Economic Burden ◽  
The United States ◽  
Primary Diagnosis ◽  
Cost Of Care ◽  
Hospital Charges ◽  
Inpatient Mortality ◽  
The Us

Abstract Background There is limited data addressing the epidemiology, costs, and outcomes of Clostridium difficile infection (CD) in hospitalized patients in the United States (U.S.). This study aims to estimate the characteristics, outcomes, and economic burden of patients hospitalized for CD in the US. Methods The Nationwide Inpatient Sample (NIS) database was used to obtain data from 2000–2014. The NIS contains data from over 7 million hospitalizations in the US per year, generalizable to the American population. The NIS was queried for ICD-9 codes for either a primary or secondary diagnosis of CD (008.45). Information for demographic data, length of stay (LOS), mortality, and hospital charges was evaluated. Results There were 1,256,783 total discharges from 2000–2014 with CD as the primary diagnosis and 4,204,338 total discharges during the same period with CD listed as any diagnosis. The number of hospitalizations with CD as primary diagnosis increased from 31,782 in 2000 to 107,760 in 2014. The number of hospitalizations with CD listed as any diagnosis increased from 134,518 to 361,945. Mean LOS decreased from 6.8 to 5.8 days and mean charges per hospitalization increased from $15,810 to $35,898 during the same time period. Aggregate charges increased from $0.51 billion to $3.87 billion annually. Inpatient mortality of CD hospitalizations decreased from a 4.03% in 2005 to 1.67% in 2014. Approximately 42% of those admitted for CD were male and 58% were female. Conclusion This study demonstrates that the number of hospitalizations for CD has increased by 339% from 2000 to 2014. Inpatient mortality of CD has decreased, likely from earlier recognition and treatment of CD. The direct cost of admissions with CD as primary diagnosis is nearly $4 billion per year. Our findings affirm that CD infection is an epidemic that remains a significant source of morbidity and mortality with substantial hospitalization and cost burden. This data can be used to support a return on investment for intervention strategies to prevent CD transmission and for new therapies. Disclosures All authors: No reported disclosures.

Reducing nonfatal suicidal behaviour among university students: actuarial analysis of potential effects of treating common mental disorders

2020 ◽  
pp. 008124632097383
Author(s):  
Jason Bantjes ◽  
Elsie Breet ◽  
Christine Lochner ◽  
Janine Roos ◽  
Ronald C Kessler ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Mental Disorders ◽  
Risk Analysis ◽  
Suicidal Behaviour ◽  
Suicide Ideation ◽  
Common Mental Disorders ◽  
Population Attributable Risk ◽  
Attributable Risk ◽  
Potential Reduction ◽  
Increased Risk

Campus-based suicide prevention is an important priority for universities. One approach could be to identify and treat common mental disorders, but it is unclear what potential reduction in suicide might be achieved by such an approach. Our aim was to quantify this potential effect on prevalence of nonfatal suicidal behaviour among first-year students. Data were collected from students at two South African universities ( N = 633) via an online survey. We assessed prevalence of nonfatal suicidal behaviour and six common mental disorders and used logistic regression models to identify all main and interaction associations of sociodemographic variables and common mental disorders as predictors of nonfatal suicidal behaviour. Population attributable risk analysis was used to quantify the potential reduction in nonfatal suicidal behaviour achieved by effectively treating common mental disorders, based on the simplifying assumption that the logistic regression coefficients of the common mental disorders represented causal effects on nonfatal suicidal behaviour. Twelve-month prevalence of suicidal ideation, plan, and attempt were 40.9%, 22.3%, and 3.9%, respectively. Increased risk was associated with identifying as Black, female and reporting an atypical sexual orientation. Of the six common mental disorders, major depressive disorder and generalised anxiety disorder were associated with all dimensions of nonfatal suicidal behaviour, bipolar spectrum disorder with increased risk of ideation and plan, attention-deficit/hyperactivity disorder with ideation, and alcohol use disorder with suicide plan. Population attributable risk analysis suggests that treating common mental disorders could yield absolute reductions in suicide ideation, plan, and attempt of 17.0%, 55.0% and 73.8%, respectively. Pragmatic trials are needed to evaluate the effects on nonfatal suicidal behaviour of identifying and treating students with a prior history of common mental disorder early in their university careers.

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