Hospital Use and Mortality in Transition-Aged Patients With Sickle Cell Disease

2021 ◽  
Author(s):  
Titilope Fasipe ◽  
Deepa Dongarwar ◽  
Elyse Lopez ◽  
Ria Brown ◽  
Megan Abadom ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Hospital Mortality ◽  
Sickle Cell ◽  
International Classification Of Diseases ◽  
Mortality Rates ◽  
Cell Disease ◽  
Annual Percent Change ◽  
Percent Change ◽  
Classification Of Diseases

OBJECTIVES Childhood mortality in sickle cell disease (SCD) has decreased, but the transition period is associated with poor outcomes and higher mortality rates. We analyzed recent US hospitalizations and mortality trends in the transition-aged population and evaluated for differences between patients with and without SCD. METHODS Nationwide Inpatient Sample database was used to analyze hospitalizations among individuals aged 16 to 24 years from 2003 to 2017. Diagnoses were coded by using International Classification of Diseases, Ninth Revision, Clinical Modification and International Classification of Diseases, 10th Revision, Clinical Modification. We performed bivariate analyses to assess associations between sociodemographic characteristics and SCD hospitalizations, joinpoint regression analysis to describe mortality rate trends in SCD hospitalizations, and adjusted survey logistic regression to assess associations between patient characteristics and in-hospital mortality among transition-aged SCD and non-SCD-related hospitalizations. RESULTS There were 37 344 532 hospital encounters of patients aged 16 to 24 years during 2003–2017; both SCD and non-SCD hospitalizations increased with age. Female patients accounted for 78% of non-SCD and 54.9% of SCD hospitalizations. Although there was a +3.2% average annual percent change in SCD hospitalizations, total SCD in-hospital mortality rates did not have a statistically significant increase in average annual percent change over the study period. Patients with SCD aged 19 to 21 and 22 to 24 were more likely to suffer in-hospital mortality than those aged 16 to 18 (odds ratio = 2.09 and 2.71, respectively); the increased odds in mortality by age were not seen in our non-SCD population. CONCLUSIONS Transition-aged hospitalizations increase with age, but SCD hospitalizations have disparate age-related mortality rates. Hospital-based comprehensive care models are vital to address the persistent burden of early adulthood mortality in SCD.

scholarly journals Validity of International Classification of Diseases Codes for Sickle Cell Trait and Sickle Cell Disease

2019 ◽  
Vol 35 (4) ◽  
pp. 1323-1324
Author(s):  
Kabir O. Olaniran ◽  
Harish Seethapathy ◽  
Sophia H. Zhao ◽  
Andrew S. Allegretti ◽  
Sahir Kalim ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Sickle Cell Trait ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Cell Disease ◽  
Classification Of Diseases

Abstract P096: Trends in Heart Disease Mortality Among Mississippi Adults Over a Three Decade Period, 1980 Through 2013

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Vincent L. Mendy ◽  
Rodolfo Vargas ◽  
Lamees El-sadek ◽  
Abigail Gamble
Keyword(s):  
Heart Disease ◽  
Cause Of Death ◽  
International Classification Of Diseases ◽  
Mortality Rates ◽  
Vital Statistics ◽  
Annual Percent Change ◽  
Percent Change ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Underlying Cause Of Death

Background: Heart disease (HD) mortality has declined in Mississippi over recent decades however it remains as the leading cause of death among Mississippians. Trends in Mississippi HD mortality have not been thoroughly explored. This study examined trends in HD mortality from 1980 through 2013 among Mississippi adults (≥ 25 years) and further assessed trends by race and sex. Methods and Results: Data from Mississippi Vital Statistics (1980 through 2013) were used to calculate age-specific HD mortality rates for Mississippi adults. Cases were identified using underlying cause of death codes from the International Classification of Diseases, Tenth Revision (ICD-10), including I00-I09, I11, I13, and I20-I51. Joinpoint software was used to calculate the average annual percent change in HD mortality rates for the overall population and by race, sex, and race and sex. Overall, the age-adjusted HD mortality rates among Mississippi adults decreased by 36.5% between 1980 and 2013 with an average annual percent change of -1.60% (95% CI -2.0 to -1.3). During this period, HD mortality rates decreased annually on average by -1.30% (95% CI -1.98 to -0.69) for black adults; by -1.60% (95% CI -1.74 to -1.46) for white adults; by -1.30% (95% CI -1.5 to -1.1) for all females, and by -1.90% (95% -2.2 to -1.5) for all males. Conclusions: Between 1980 and 2013 a continual decrease in HD mortality among Mississippi adults was observed. Disparities in the magnitude of the decrease in HD mortality existed by race and sex.

scholarly journals Opioid Use Is NOT Associated with in-Hospital Mortality Among Patients with Sickle CELL Disease in the United States: Findings from the National Inpatient Sample

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 315-315
Author(s):  
Oladimeji Akinola Akinboro ◽  
Stanley Nwabudike ◽  
Camille Edwards ◽  
Diana Cirstea ◽  
Nana Oduraa Addo-Tabiri ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Hospital Mortality ◽  
Sickle Cell ◽  
The United States ◽  
Mortality Rates ◽  
Opioid Epidemic ◽  
Cell Disease ◽  
Annual Increase ◽  
Hospitalization Rates ◽  
The Us

Abstract Background Vaso-occlusive pain crises account for the majority of hospitalizations in patients with sickle cell disease (SCD), and opioids are the mainstay of chronic pain control in SCD. However, a marked increase in opioid-related overdoses and deaths in the United States (US) - 'the US opioid epidemic' - has been documented since 2000. We sought to: i) examine temporal trends in hospitalization rates and in-hospital mortality rates among adults with SCD since the onset of the US opioid epidemic, and ii) compare in-hospital mortality rates for SCD with the rates of opioid prescription-related deaths in the non-SCD general population since the onset of the US opioid epidemic. Methods We obtained data from the National Inpatient Sample from 1998 through 2013. We identified hospitalizations for patients with sickle cell disease using discharge diagnoses (ICD-9-CM) codes 282.41, 282.42, 282.60, 282.61, 282.62, 282.63, 282.64, 282.68, and 282.69. We examined hospitalization and in-hospital mortality rates and trends for the entire sample of SCD patients, as well as by the following age groups: 0-17 years, 18-44 years, 45-64 years, and ≥65 years. We also examined in-hospital mortality hospitalization trends by U.S Census Bureau regions viz: Northeast, Midwest, South, and West. Survey weights were applied in estimating the population-based hospitalization rates. We utilized annual mid-year population figures provided by the US Census Bureau as the reference population for each year. Survey analysis and trend analyses were performed with Stata 14.2®(StataCorp, College Station, TX), and Joinpoint Regression Program 4.2.02® (National Cancer Institute), respectively. Results There were 1,755,220 hospitalizations among SCD patients in the US from 1998 to 2013. Hospitalization rates for SCD patients initially declined annually by 9.9% (95% CI: 4.0, 15.5) from 39/100,000 persons in 1998 to 27/100,000 persons in 2002, but no significant temporal trends were noted from 2002 to 2013 (figure 1). However, among young adults with SCD (18-44 years), there was a significant annual increase in hospitalization rates by 3.8% (95% CI: 2.4%, 5.2) from 43/100,000 persons in 2002 to 71/100,000 persons in 2013. Elderly SCD patients (≥65 years) also had a significant annual increase in hospitalization rates by 6.5% (95% CI: 2.9%, 10.2%) from 2.7/100,000 persons in 1998 to 5.4/100,000 persons in 2013. The only region with a significant increase in SCD hospitalization rate was the South with an annual increase of 3.5% (95% CI: 0.6, 6.4) from 2001 through 2011.There was no significant increase in-hospital SCD mortality, in contrast to the 350% increase in non-SCD opioid prescription-related death rates in the US from 1999 through 2013 (figure 2). Conclusion Hospitalization rates are rising among most age-groups of adults with SCD. The reasons for this finding are unclear but the rising rates may reflect the fragmentation of care for SCD in adults as well as age-related increases in pain-related comorbidities and SCD complications as SCD patients live longer. However, there has been no associated increase in-hospital SCD mortality, supporting extant data which suggest that the rate of opioid-related deaths in SCD is low, and the use of opioids for pain control may be considered relatively safe in the SCD population. Disclosures No relevant conflicts of interest to declare.

Abstract 14682: Impact of Atrial Fibrillation in Aortic Stenosis Patients: Insights From the United States Readmissions Database

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Shashank Shekhar ◽  
Anas M Saad ◽  
Toshiaki Isogai ◽  
Mohamed M Gad ◽  
Keerat Ahuja ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Aortic Stenosis ◽  
Hospital Mortality ◽  
Large Scale ◽  
International Classification Of Diseases ◽  
The United States ◽  
Large Scale Data ◽  
Classification Of Diseases

Introduction: Even though atrial fibrillation (AF) is present in >30% of patients with aortic stenosis (AS), it is not typically included in the decision-making algorithm for the timing or need for aortic valve replacement (AVR), either by transcatheter (TAVR) or surgical (SAVR) approaches. Large scale data on how AF affects outcomes of AS patients remain scarce. Methods: From the Nationwide Readmissions Database (NRD), we retrospectively identified AS patients aged ≥18years, with and without AF admitted between January and June in 2016 and 2017 (to allow for a six month follow up), using the International Classification of Diseases-10 th revision codes. Multivariable logistic regression was performed to examine the predictors of in-hospital mortality during index hospitalization. In-hospital complications and 6 month in-hospital mortality during any readmission after being discharged alive were compared in patients with and without AF, for patients undergoing TAVR, SAVR or no-AVR. Results: We identified 403,089 AS patients, of which 41% had AF. Patients with AF were older (median age in years: 83 vs. 79) and were more frequently females (52% vs. 48%; p<0.001). Table summarizes outcomes of AS patients with and without AF. TAVR in patients with AF was associated with higher in-hospital mortality and follow-up mortality as compared to patients without AF. Although AF did not influence in-hospital mortality in SAVR population, follow-up mortality was also significantly higher after SAVR in patients with AF compared to patients without AF. For patients not undergoing AVR, in-hospital and follow-up mortality were higher in AF population compared to no AF and was higher than patients undergoing AVR (Table). Conclusions: AF is associated with worse outcomes in patients with AS irrespective of treatment (TAVR, SAVR or no-AVR). More studies are needed to understand the implications of AF in AS population and whether earlier treatment of AS in patients with AF can improve outcomes.

scholarly journals Acute Kidney Injury and In-Hospital Mortality: A Retrospective Analysis of a Nationwide Administrative Database of Elderly Subjects in Italy

2019 ◽  
Vol 8 (9) ◽  
pp. 1371 ◽  
Author(s):  
Fabbian ◽  
Savriè ◽  
De Giorgi ◽  
Cappadona ◽  
Di Simone ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Hospital Mortality ◽  
Kidney Injury ◽  
International Classification Of Diseases ◽  
Administrative Database ◽  
Elderly Subjects ◽  
Dialysis Treatment ◽  
The Third ◽  
Classification Of Diseases

Background: The aim of this study was to investigate the association between acute kidney injury (AKI) and in-hospital mortality (IHM) in a large nationwide cohort of elderly subjects in Italy. Methods: We analyzed the hospitalization data of all patients aged ≥65 years, who were discharged with a diagnosis of AKI, which was identified by the presence of the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM), and extracted from the Italian Health Ministry database (January 2000 to December 2015). Data regarding age, gender, dialysis treatment, and comorbidity, including the development of sepsis, were also collected. Results: We evaluated 760,664 hospitalizations, the mean age was 80.5 ± 7.8 years, males represented 52.2% of the population, and 9% underwent dialysis treatment. IHM was 27.7% (210,661 admissions): Deceased patients were more likely to be older, undergoing dialysis treatment, and to be sicker than the survivors. The population was classified on the basis of tertiles of comorbidity score (the first group 7.48 ± 1.99, the second 13.67 ± 2,04, and third 22.12 ± 4.13). IHM was higher in the third tertile, whilst dialysis-dependent AKI was highest in the first. Dialysis-dependent AKI was associated with an odds ratios (OR) of 2.721; 95% confidence interval (CI) 2.676–2.766; p < 0.001, development of sepsis was associated with an OR of 1.990; 95% CI 1.948–2.033; p < 0.001, the second tertile of comorbidity was associated with an OR of 1.750; 95% CI 1.726–1.774; p < 0.001, and the third tertile of comorbidity was associated with an OR of 2.522; 95% CI 2.486–2.559; p < 0.001. Conclusions: In elderly subjects with AKI discharge codes, IHM is a frequent complication affecting more than a quarter of the investigated population. The increasing burden of comorbidity, dialysis-dependent AKI, and sepsis are the major risk factors.

scholarly journals New classification of peripheral retinal vascular changes in sickle cell disease.

1994 ◽  
Vol 78 (9) ◽  
pp. 681-689 ◽  
Author(s):  
A D Penman ◽  
J F Talbot ◽  
E L Chuang ◽  
P Thomas ◽  
G R Serjeant ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Vascular Changes ◽  
Cell Disease ◽  
New Classification

Cochlear and Neural Diseases: Classification and Oto-Audiologic Correlations

1974 ◽  
Vol 83 (3) ◽  
pp. 304-311 ◽  
Author(s):  
Richard E. Marcus
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Alport's Syndrome ◽  
Clinical Classification ◽  
Cell Disease ◽  
Alport’S Syndrome ◽  
Pathologic Findings ◽  
Definition Of ◽  
Neural Diseases

An extended clinical classification of cochlear and neural disease is presented along with an anatomical definition of corresponding cochlear and neural compartments. The clinical classification has three categories: prenatal, neonatal, and delayed, with each subdivided into genetic and acquired groups. The cochlear and neural compartments are arbitrarily divided at the habenula perforata with the unmyelinated dendrites considered part of the cochlear compartment. This allows a clinical reconciliation of cochlear and neural disease with oto-audiologic and pathologic findings. Patients are presented with Alport's syndrome, meningitis and obliterative labyrinthitis, mumps, diabetes and sickle cell disease to illustrate the clinical classification. Pathologic correlations are postulated in each of the patients.

scholarly journals Mortality Rates and Age at Death from Sickle Cell Disease: U.S., 1979–2005

2013 ◽  
Vol 128 (2) ◽  
pp. 110-116 ◽  
Author(s):  
Sophie Lanzkron ◽  
C. Patrick Carroll ◽  
Carlton Haywood
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Mortality Rates ◽  
Age At Death ◽  
Cell Disease

scholarly journals MORPHOLOGICAL ANALYSIS OF CELLS BY MEANS OF AN ELASTIC METRIC IN THE SHAPE SPACE

2020 ◽  
Author(s):  
Irene Epifanio ◽  
Ximo Gual-Arnau ◽  
Silena Herold-Garcia
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Morphological Analysis ◽  
Feature Space ◽  
Shape Space ◽  
Cell Disease ◽  
Planar Curves ◽  
Infinite Dimensional ◽  
First Time

Shape analysis is of great importance in many fields, such as computer vision, medical imaging, and computational biology. This analysis can be performed considering shapes as closed planar curves in the shape space. This approach has been used for the first time to obtain the morphological classification of erythrocytes in digital images of sickle cell disease considering the shape space S1, which has the property of being isometric to an infinite-dimensional Grassmann manifold of two-dimensional subspaces (Younes et al., 2008), without taking advantage of all the features offered by the elastic metric related to the possibility of stretching and bending of the curves. In this paper, we study this deformation in the shape space, S2, which is based on the representation of closed planar curves by means of the square-root velocity function (SRVF) (Srivastava et al., 2011), using the elastic metric of this space to obtain more efficient geodesics and geodesic lengths between planar curves. Supervised classification with this approach achieved an accuracy of 94.3%, classification using templates achieved 94.2% and unsupervised clustering in three groups achieved 94.7%, considering three classes of erythrocytes: normal, sickle, and with other deformations. These results are better than those previously achieved in the morphological analysis of erythrocytes and the method can be used in different applications related to the treatment of sickle cell disease, even in cases where it is necessary to study the process of evolution of the deformation, something that can not be done in a natural way in the feature space.

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