Risk Factors for Gastrojejunal Anastomosis Ulcer and Inpatient Mortality: Analysis of the Nationwide Inpatient Sample Database

2017 ◽  
Vol 112 ◽  
pp. S1473
Author(s):  
Yasir Al-Abboodi ◽  
Matthew Fasullo ◽  
Tarek Naguib
Keyword(s):  
Risk Factors ◽  
Nationwide Inpatient Sample ◽  
Gastrojejunal Anastomosis ◽  
Inpatient Mortality ◽  
Nationwide Inpatient Sample Database ◽  
Mortality Analysis

scholarly journals 765. Pyomyositis in the United States: Trends and Associations From the Healthcare Utilization Project Nationwide Inpatient Sample Database

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S340-S341
Author(s):  
Rheanne K Maravelas ◽  
Thomas Melgar ◽  
Sapna Sadarangani ◽  
Neiberg Lima ◽  
Zachary Rich ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
United States ◽  
Risk Factors ◽  
Healthcare Utilization ◽  
Nationwide Inpatient Sample ◽  
Myositis Ossificans ◽  
Organ Transplant ◽  
The United States ◽  
Nationwide Inpatient Sample Database ◽  
Duration Of Hospitalization

Abstract Background Pyomyositis is a spontaneous infection of skeletal muscle that can lead to abscess formation and sepsis. The purpose of our study was to better describe the characteristics, risk factors, and trends of primary pyomyositis in the United States. Methods This study is a retrospective review of data from the Healthcare Utilization Project Nationwide Inpatient Sample Database from 2002 to 2014. We systematically searched ICD-9 codes and included diagnoses of infective myositis and/or tropical pyomyositis and excluded progressive myositis ossificans and/or traumatic myositis ossificans. We compiled lists of codes for co-occurring infections, candidate risk factors, and microbiological data. Each group of related ICD-9 codes was combined into a single composite indicator. SAS studio was utilized for analysis. Results The database included a total of 100,790,900 discharges accounting for 482,872,274 weighted discharges with 13,011 pyomyositis cases accounting for 62,657 weighted cases. The patients with pyomyositis were significantly more likely to be younger, male, and have a longer duration of hospitalization. The proportion of discharges with pyomyositis has steadily risen more than 3-fold from 0.0054% to 0.0209%. Of the cases of pyomyositis, a minority had co-occurring deep tissue infections: 16.9% had osteomyelitis and 8.8% had septic arthritis. We found significantly higher rates of co-occurrence with HIV, diabetes mellitus, organ transplant, alcohol abuse, and chronic kidney disease compared with the general hospitalized population, suggesting these as relevant risk factors. When microorganisms were diagnosed, Staphylococus aureus was most common, followed by Streptococcus spp. Conclusion Our study identified a rapid increase in pyomyositis cases in the United States over our 12-year study period. Our results substantiate risk factors for pyomyositis related to immunosuppression and suggest that diabetes mellitus may be an important risk factor in the United States. Identifying causative organisms is helpful for empiric treatment. It is important that clinicians be aware of this emerging diagnosis relevant in both temperate and tropical areas of the globe. Disclosures All authors: No reported disclosures.

scholarly journals Outcomes of transcatheter mitral valve repair from the latest nationwide inpatient sample database 2016–2017

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H Mehta ◽  
K Kurpad ◽  
A Okoh ◽  
S Singh ◽  
J Berman ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Mitral Valve ◽  
Length Of Stay ◽  
Mitral Valve Repair ◽  
Nationwide Inpatient Sample ◽  
Inpatient Mortality ◽  
Valve Repair ◽  
Transcatheter Mitral Valve Repair ◽  
Nationwide Inpatient Sample Database ◽  
Alternative Treatment Option

Abstract Background Transcatheter mitral valve repair (TMVR) is an alternative treatment option for severe mitral regurgitation (severe MR) in patients with high surgical risk. Previous studies have demonstrated safety and efficacy of TMVR. The aim of our study was to assess comorbid and patient outcome data in a nationwide sample. Methods From the Nationwide Inpatient Sample (NIS) 2016–2017, all adult patients with mitral valve regurgitation were identified. Patients were divided into two group- TMVR and SMVR (surgical mitral valve repair). Patients requiring surgical valve replacement were excluded. Primary outcomes were inpatient mortality and length of stay. Multivariate analysis was performed to adjust for comorbidities. Results A total of 6211 TMVR were performed, while 3789 SMVR were performed. TMVR patients were older (78.34 vs 62.26 years) and had more females (48.86 vs 36.18%). Comorbidities were higher in the TMVR group [heart failure (81.02 vs 46.02%, p<0.001), diabetes mellitus (27.13 vs 15.81%, p<0.001), chronic kidney disease (39.3 vs 13.7%, p<0.001), chronic lung disease (27.13 vs 16.65%, p<0.001). Complications were higher in the SMVR [Cardiogenic shock (3.8 vs 6%, p=0.007), blood transfusion requirement (19.44 vs 4.85%, p=0.001), respiratory failure (10.99 vs 7.37, p=0.012)]. Mean length of stay was higher with SMVR [8.60±0.22 (4.139–5.17) days] compared to TMVR [4.65±0.26 (8.167–9.03) days]. In-patient mortality was lower in TMVR (2.01 vs 2.45%, p-0.02). After adjusting for comorbidities on multivariate analysis, there was no difference in mortality between the groups (adjusted OR=1.081±0.419 (0.506–2.311). Conclusion From nationwide data, we report TMVR as a relatively safe treatment modality for severe MR, with comparable inpatient mortality and fewer complications than SMVR, despite having a significantly higher burden of comorbidities. Funding Acknowledgement Type of funding source: None

Mortality Among Neutropenic Cancer Patients Within the United States: The Association With Hospital Volume

2021 ◽  
pp. OP.20.00115
Author(s):  
Damien Urban ◽  
Gavin E. Urban ◽  
Ofer Margalit ◽  
Uri Amit ◽  
Galia Jacobson ◽  
...  
Keyword(s):  
Large Volume ◽  
Hospital Volume ◽  
Nationwide Inpatient Sample ◽  
Small Volume ◽  
The United States ◽  
Median Number ◽  
Inpatient Mortality ◽  
Nationwide Inpatient Sample Database ◽  
Adult Inpatient ◽  
Neutropenic Patients

PURPOSE: Neutropenia is a serious complication of chemotherapy in patients with solid tumors. The influence of hospital volume on outcomes in patients with neutropenia has been little investigated. We hypothesized that large-volume hospitals would have reduced mortality rates for neutropenic patients compared with small-volume institutions. METHODS: We used the Nationwide Inpatient Sample database of the Healthcare Cost and Utilization Project, for the years 2007-2011. All adult inpatient episodes with a diagnosis of both neutropenia and solid-tumor malignancy were included. Hospital volume was defined as the number of neutropenic cancer episodes per institution per year. Mortality was defined as death during admission. A multilevel mixed-effects logistic regression model was applied. RESULTS: Twenty thousand three hundred and ten hospitalizations were included in the study, from 1,869 different institutions. Median age was 62 years. The overall inpatient mortality was 2.3%, and was dependent on age (age 50-59 years—1.6% and age 80-89 years—5.3%). The median number of neutropenic inpatient episodes in each institution per year was 14 (range, 1-168). Mortality was 3.3%, 2.7%, 2.2%, 2.2%, and 1.2% for each quintile of hospital volume (from lowest to highest volume, P < .001). Likewise, the proportion discharged home was 85.7%, 90.3%, 91.5%, 92.7%, and 95.4% ( P < .001). The association between hospital volume and mortality remained significant after adjustment for patient-level and hospital-level variables. DISCUSSION: Patients with neutropenia hospitalized in large-volume institutions have a substantially lower mortality compared with those hospitalized at low-volume institutions. Further study is required to validate our findings or overcome potential biases, understand mechanism, and investigate how smaller institutions can improve outcomes.

scholarly journals Incidence and Risk Factors of In-hospital Prosthesis-Related Complications Following Total Shoulder Arthroplasty

2021 ◽  
Author(s):  
Qinfeng Yang ◽  
Hao Xie ◽  
Shencai Liu ◽  
Xuanping Wu ◽  
Zhanjun Shi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Native American ◽  
Length Of Stay ◽  
Shoulder Arthroplasty ◽  
Nationwide Inpatient Sample ◽  
Shoulder Arthroscopy ◽  
Metastatic Cancer ◽  
Total Shoulder Arthroplasty ◽  
American Hospital ◽  
Nationwide Inpatient Sample Database

Abstract BackgroundThe occurrence of prosthesis-related complications after total shoulder arthroplasty is devastating and costly. The purpose was to determine the incidence and risk of in-hospital prosthesis-related complications after total shoulder arthroplasty utilizing a large-scale sample database.MethodsA retrospective database analysis was performed based on Nationwide Inpatient Sample from 2010 to 2014. Patients who underwent total shoulder arthroplasty were included. Patient demographics, hospital characteristics, length of stay, economic indicators, in-hospital mortality, comorbidities, and peri-operative complications were evaluated.ResultsA total of 34,198 cases were capture from the Nationwide Inpatient Sample database. There were 343 cases of in-hospital prosthesis-related complications after total shoulder arthroplasty and the overall incidence was 1%, with a more than 2.5-fold decrease from 2010 to 2014. Dislocation was the most common category among prosthesis-related complications (0.1%). The occurrence of in-hospital prosthesis-related complications was associated with significantly more total charges and slightly longer length of stay while less usage of Medicare. Risk factors of prosthesis-related complications were identified including younger age (<64 years), female, the native American, hospital in the South, alcohol abuse, depression, uncomplicated diabetes, diabetes with chronic complications, fluid and electrolyte disorders, metastatic cancer, neurological disorders, and renal failure. Interestingly, advanced age (≥65 years) and proprietary hospital were found as protective factors. Furthermore, prosthesis-related complications were associated with aseptic necrosis, rheumatoid arthritis, rotator cuff tear arthropathy, Parkinson’s disease, prior shoulder arthroscopy, and blood transfusion.ConclusionsIt is of benefit to study risk factors of prosthesis-related complications following total shoulder arthroplasty to ensure the appropriate management and optimize consequences although a relatively low incidence was identified.

Trends and Outcomes of Venous Thromboembolism in Hospitalized Patients With Ovarian Cancer: Results From Nationwide Inpatient Sample Database 2003 to 2011

2018 ◽  
Vol 28 (8) ◽  
pp. 1478-1484 ◽  
Author(s):  
Varun Mittal ◽  
Shradha Ahuja ◽  
Sai Sharath Vejella ◽  
Jessica M. Stempel ◽  
Venkataraman Palabindala ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Venous Thromboembolism ◽  
Length Of Stay ◽  
Cancer Patients ◽  
Nationwide Inpatient Sample ◽  
Hospitalized Patients ◽  
Annual Number ◽  
Binary Logistic Regression Analysis ◽  
Inpatient Mortality ◽  
Nationwide Inpatient Sample Database

ObjectiveVenous thromboembolism (VTE) is a major cause of mortality and morbidity in hospitalized patients with malignancy. Nationwide Inpatient Sample database was analyzed to determine the trends in the rate of hospitalization and mortality from VTE in hospitalized ovarian cancer patients and assess its economic impact and resource utilization.MethodWe queried the 2003 to 2011 Nationwide Inpatient Sample database from Healthcare Cost and Utilization project (Agency of Healthcare Research and Quality) to identify all adults (age ≥18 years) ovarian cancer. Patients hospitalized with VTE as one of the top 3 discharge diagnoses were also identified. Demographic characteristics and in-hospital outcomes of this population were compared with ovarian cancer patients without VTE. Binary logistic regression analysis was used to obtain adjusted odds ratios (ORs).ResultsA total of 34,249 (3.5%) of a total of 981,386 hospitalized ovarian cancer patients had an accompanying diagnosis of VTE. Mean age of the study population was 64 years. After adjusting for potential confounders, compared with those without VTE, ovarian cancer patients with VTE had significantly higher inpatient mortality (6.2% vs 4.3%; OR, 1.12 [confidence interval (CI), 1.06–1.17]; P < .001), longer length of stay (5 vs 4 days; OR, 1.40 [CI, 1.36–1.43]; P < .001), higher average cost of hospitalization (US $26,000 vs US $22,000; OR, 1.10 [CI, 1.07–1.13]; P < .001), and greater disability at discharge (OR, 1.34 [CI, 1.31–1.38]; P < .001). Although the annual number of VTE admissions in ovarian cancer patients increased, in-hospital mortality declined from 10.9% in 2003 to 5.3% in 2011.ConclusionsVenous thromboembolism in hospitalized patients with ovarian cancer is associated with higher inpatient mortality, length of stay, higher cost of hospitalization, and disability at discharge. The hospitalization rate has increased, but the inpatient mortality rate has declined over study period.

Delays in antibiotic redosing: Association with inpatient mortality and risk factors for delay

2021 ◽  
Author(s):  
Charles B. Kemmler ◽  
Rohit B. Sangal ◽  
Craig Rothenberg ◽  
Shu-Xia Li ◽  
Frances S. Shofer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inpatient Mortality
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