scholarly journals Hospitalization burden and comorbidities of patients with rheumatoid arthritis in Spain during the period 2002-2017

2020 ◽  
Author(s):  
Mario Gil-Conesa ◽  
Juan Antonio Del-Moral-Luque ◽  
Ruth Gil-Prieto ◽  
Ángel Gil-de-Miguel ◽  
Ramón Mazzuccheli-Esteban ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Circulatory System ◽  
Length Of Hospital Stay ◽  
Hospitalization Rate ◽  
Main Diagnosis ◽  
Autoimmune Rheumatic Disease ◽  
Hospitalization Rates ◽  
The Mean ◽  
Spanish Health ◽  
Observational Descriptive Study

Abstract Background: Rheumatoid arthritis (RA) is a chronic autoimmune rheumatic disease that is associated with multiple comorbidities and has a significant economic impact on the Spanish health system. The objective of this study was to estimate the rates of hospitalization of rheumatoid arthritis in Spain, and describing hospitalization rates and it's changing by age, region, RA variant, and when RA as a main cause of hospitalization or a comorbidity. Methods: Observational descriptive study that reviewed hospital records from the CMBD. We included all hospitalizations of patients in Spain whose main diagnosis or comorbidity in the ICD-9-CM was rheumatoid arthritis during the period of 2002-2017. Results: A total of 315,190 hospitalizations with the RA code were recorded; 67.3% were in women. The mean age of the patients was 68.5 ± 13.9 years. The median length of hospital stay was 7 days (IQR 3-11 days). In 29,809 of the admissions, RA was coded as the main diagnosis (9.4%). When RA was not coded as the main diagnosis, the most frequent main diagnoses were diseases of the circulatory system (18.9%) and diseases of the respiratory system (17.4%). The hospitalization rate during the period of 2002-2017 was 43.8 (95% CI: 43.7-44.0) per 100,000 inhabitants. The total cost for the healthcare system was 1.476 million euros, with a median of 3,542 euros per hospitalization (IQR 2,646-5,222 euros). Conclusions: In Spain, the hospitalization rate of patients with RA increased during the study period, despite the decrease in the hospitalization rate when RA was the main diagnosis.

scholarly journals Epidemiology and comorbidities of patients with rheumatoid arthritis in Spain during the period 2002-2017

2019 ◽  
Author(s):  
Juan Antonio Del-Moral-Luque ◽  
Mario Gil-Conesa ◽  
Ruth Gil-Prieto ◽  
Ángel Gil-de-Miguel ◽  
Ramón Mazzuccheli-Esteban ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Circulatory System ◽  
Length Of Hospital Stay ◽  
Hospitalization Rate ◽  
Main Diagnosis ◽  
Autoimmune Rheumatic Disease ◽  
Hospitalization Rates ◽  
Spanish Health ◽  
Observational Descriptive Study ◽  
Continental Climate

Abstract Background: Rheumatoid arthritis (RA) is a chronic autoimmune rheumatic disease that is associated with multiple comorbidities and has a significant economic impact on the Spanish health system. The objective of this study was to estimate the hospital burden of rheumatoid arthritis, its variants and their associated comorbidities. Methods: Observational descriptive study that reviewed hospital records from the CMBD. We included all hospitalizations of patients in Spain whose main diagnosis or comorbidity in the ICD-9-CM was rheumatoid arthritis during the period of 2002-2017. Results: A total of 315,190 hospitalizations with the RA code were recorded; 67.3% were in women. The mean age of the patients was 68.5 ± 13.9 years. The median length of hospital stay was 7 days (IQR 3-11 days). In 29,809 of the admissions, RA was coded as the main diagnosis (9.4%). When RA was not coded as the main diagnosis, the most frequent main diagnoses were diseases of the circulatory system (18.9%) and diseases of the respiratory system (17.4%). The hospitalization rate during the period of 2002-2017 was 43.8 (95% CI: 43.7-44.0) per 100,000 inhabitants. The total cost for the healthcare system was 1.476 million euros, with a median of 3,542 euros per hospitalization (IQR 2,646-5,222 euros). Conclusions: In Spain, the highest hospitalization rates for RA were registered within the continental climate region. The hospitalization rate of patients with RA increased during the study period, despite the decrease in the hospitalization rate when RA was the main diagnosis.

Trend of hospital utilization for encephalitis

2011 ◽  
Vol 140 (4) ◽  
pp. 753-764 ◽  
Author(s):  
P. BARBADORO ◽  
A. MARIGLIANO ◽  
A. RICCIARDI ◽  
M. M. D'ERRICO ◽  
E. PROSPERO
Keyword(s):  
Potential Role ◽  
Viral Encephalitis ◽  
Seasonal Pattern ◽  
Hospitalization Rate ◽  
Preventive Interventions ◽  
Emerging Pathogens ◽  
Hospitalization Rates ◽  
Not Otherwise Specified ◽  
The Mean

SUMMARYEncephalitis generally results in a serious illness requiring hospitalization. The aim of this study was to describe the epidemiology of hospitalization for encephalitis in Italy, taking into account the geographical distribution, aetiology, seasonality and evolution of hospitalization rates over recent years. The mean hospitalization rate was 5·88/100 000. For most of these hospitalizations (n=13 119, 55·6%), no specific cause of encephalitis was reported. The most common aetiological category was ‘viral’, which accounted for 40·1% (n=4205) of such hospitalizations (rate 1·05/100 000). Within this category, herpes virus was the leading causative agent (n=1579, 0·39/100 000). This report highlights a significant increase of ‘viral encephalitis not otherwise specified’ (ICD-9 code 049·9) vs. a reduction of all other causes. A seasonal pattern was noted in people aged ⩾65 years in this group. Specific surveillance of encephalitis without known origin should be reinforced in order to identify the potential role of emerging pathogens and to design preventive interventions.

Positive Effect of Single-Dose Measles Vaccination in Reducing the Incidence of Pneumonia in Children with Measles

2020 ◽  
Author(s):  
Zafer Bağcı ◽  
Yunis Yusuf Daki
Keyword(s):  
Single Dose ◽  
Length Of Hospital Stay ◽  
Vaccination Rate ◽  
Hospitalization Rate ◽  
High Morbidity ◽  
Measles Vaccine ◽  
Hospitalization Rates ◽  
Training And Research ◽  
Measles Vaccination ◽  
Positive Effect

Abstract Aim Measles is a worldwide common, highly infectious and vaccine-preventable contagious disease with high morbidity and mortality rates. We investigated the effects of administering single-dose measles vaccination in children with measles on the incidence of pneumonia and hospitalization. Materials and methods We retrospectively analysed the hospital records of children aged 0–18 years who were diagnosed with measles within a year before the study in a training and research hospital in Mogadishu, Somalia. We compared the measles vaccine ratios, hospitalization rates, hospitalization duration and pneumonia development rates. Results We found that 34 (15.6%) patients had received measles vaccination, while 184 (84.4%) did not receive the vaccination. All the vaccinated patients received only a single dose of the vaccine. The proportion of those who had received pneumonia vaccine (14/34, 41.2%) was significantly lower than that of those who had never received a dose of measles containing vaccine (179/184, 97.3%) (p = 0.001). Moreover, patients who were immunized [n = 3 (3.1%)] had a significantly lower hospitalization rate than those who were not immunized [n = 94 (96.9%)] (p = 0.001). Conclusion The risk of pneumonia in children with measles vaccination, rate of hospitalization and length of hospital stay was significantly lower in children who had received even a single dose of the vaccine when compared with that in those who had not vaccinated. The results of this study reiterate the need for more effective global measles vaccination.

Abstract P11: Use of Hospital Claims Data to Estimate the Clinical and Economic Burden of Acute Coronary Syndrome Rehospitalizations in Real-World Clinical Practice

2011 ◽  
Vol 4 (suppl_2) ◽  
Author(s):  
Gregory Hess ◽  
Durgesh Bhandary ◽  
Sanjay Gandhi ◽  
Deepa Kumar ◽  
Eileen Fonseca ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Clinical Practice ◽  
Real World ◽  
Hospitalization Rate ◽  
Index Hospitalization ◽  
Coronary Syndrome ◽  
Hospitalization Rates ◽  
St Elevation ◽  
The Mean

Background: Re-hospitalization rates are emerging as quality of care measures with reimbursement implications for inpatient care. Objective: To examine the rates of inpatient re-hospitalization and economic burden of acute coronary syndrome (ACS) patient admissions in real-world clinical practice. Methods: Patients (age >18 years) with an inpatient hospitalization for ACS [ICD-9-CM codes for acute myocardial infarction or unstable angina (UA)] between 1/1/2007-4/30/2009 were identified using claims from 450 hospitals representing 4.8 million inpatient visits. All-cause and ACS-related re-hospitalizations within 30 days and 12 months after index event were evaluated. In addition, the mean inpatient admission charges resulting from inpatient re-admissions at 30 days were also estimated. Results: Of 17,904 ACS patients [52% male; mean age 70.6 (median-73.0) years)], 13.3% had diagnostic coding for ST elevation myocardial infarction (STEMI), 47.9% had coding for non-ST elevation myocardial infarction (NSTEMI), 32.2% had UA, and 6.5% had not otherwise specified (NOS) ACS. The 30-day all-cause inpatient re-hospitalization rate was 14.7% (STEMI: 12.7%, NSTEMI: 17.1%, UA: 12.5%, NOS: 10.8%) and 5.5% for an ACS-related re-hospitalization (STEMI: 7.6%, NSTEMI: 7.0%, UA: 2.8%, NOS: 3.9%). The 12-month all cause re-hospitalization rate was 37.7% (STEMI: 31.3%, NSTEMI: 39.9%, UA: 39.7%, NOS: 25.4%) and 12.5% for an ACS-related re-hospitalization (STEMI: 12.7%, NSTEMI: 14.3%, UA: 10.9%, NOS: 7.0%). For patients with ages > 65 years (N = 12,627), the 30-day all-cause and ACS-related re-hospitalization rates were 15.1% and 5.8%, respectively. The mean per patient additional charges resulting from 30-day all-cause and ACS-related re-hospitalizations in the study cohort with an index hospitalization (N=17,904) were estimated to be $13,160 and $7,216, respectively. Conclusion: High rates of re-hospitalization for ACS patients within 30 days and 12-months post-index hospitalization were observed using real-world clinical practice data. More effective therapies may provide an opportunity to improve important clinical and economic outcomes in ACS patients.

scholarly journals Classificação dos pacientes na emergência segundo a dependência da enfermagem

2019 ◽  
Vol 13 (4) ◽  
pp. 1133
Author(s):  
Fernanda Zambonin ◽  
Karen Ludimylla Bezerra Lima ◽  
Amanda Ramos de Brito ◽  
Ticiane Batista de Brito ◽  
Raphael Florindo Amorim ◽  
...  
Keyword(s):  
Intensive Care ◽  
Circulatory System ◽  
Main Diagnosis ◽  
Cross Sectional ◽  
Prolonged Length ◽  
High Dependency ◽  
El Sistema ◽  
Emergency Units ◽  
The Mean ◽  
Patient Classification System

RESUMO Objetivo: caracterizar o grau de dependência dos cuidados de enfermagem de usuários internados no setor de emergência. Método: trata-se de estudo quantitativo, transversal, de base secundária e a amostra se constituiu dos usuários internados na área de estabilização no mês de março de 2017. Utilizou-se um instrumento para os dados sociodemográficos e clínicos e o Sistema de Classificação de Pacientes (SCP) de Fugulin, Gaidzinski e Kurcgant. Realizou-se a análise estatística no programa Epi Info. Resultados: verificou-se que 62,16% (n=46) da amostra era do sexo masculino, idade média de 55,29 ± 20,76 anos, principal diagnóstico de internação as doenças do aparelho circulatório (39,19%) e média de permanência de 4,29 ± 6,59. O SPC foi aplicado 166 vezes e predominou o cuidado de intensivo (69,28%), seguido por semi-intensivo (13,86%) e de alta dependência (11,45%). Conclusão: constatou-se um elevado número de cuidados intensivos e semi-intensivos, atrelados à longa permanência no setor, o que descaracteriza as unidades de emergência como local de estabilização. Fornece-se com essa caracterização bases científicas e fidedignas para o gerenciamento hospitalar e de pessoal de enfermagem. Descritores: Administração Hospitalar; Assistência ao Paciente; Emergências; Enfermagem em Emergência; Enfermagem; Organização e Administração.ABSTRACT Objective: to characterize the degree of dependency of users hospitalized in the emergency unit with respect to nursing care. Method: this is a quantitative, cross-sectional and secondary-based study. The sample consisted of patients hospitalized in the stabilization unit in March 2017. An instrument was used to obtain sociodemographic and clinical data, and also the Patient Classification System (PCS) proposed by Fugulin, Gaidzinski and Kurcgant. Statistical analysis was performed using the Epi InfoTM software. Results: 62.16% (n=46) of the sample were male, with mean age of 55.29 ± 20.76 years. The main diagnosis of hospitalization was diseases of the circulatory system (39.19%), and the mean permanence was 4.29 ± 6.59. The PCS was applied 166 times and intensive care was prevalent (69.28%), followed by semi-intensive (13.86%) and high dependency (11.45%). Conclusion: There was a high number of intensive care and semi-intensive care provided and linked to prolonged length of stay in the sector, which mischaracterizes emergency units as patient stabilization sectors. This characterization provides scientific and trustworthy bases for hospital management and nursing personnel. Descriptors: Hospital Administration; Patient Care; Emergencies; Emergency Nursing; Nursing; Organization and Administration.RESUMEN Objetivo: caracterizar el grado de dependencia de los usuarios internados en el sector de emergencia en relación a los cuidados de enfermería. Método: se trata de un estudio cuantitativo, transversal y de base secundaria. La muestra se compuso de los usuarios internados en la unidad de estabilización durante el mes de marzo de 2017. Se utilizó un instrumento para obtener los datos sociodemográficos y clínicos y el Sistema de Clasificación de Pacientes (SCP) de Fugulin, Gaidzinski y Kurcgant. Se realizó el análisis estadístico en el programa Epi InfoTM. Resultados: se verificó que el 62,16% (n=46) de la muestra era del sexo masculino, con edad media de 55,29 ± 20,76 años. El principal diagnóstico de internación fue las enfermedades del aparato circulatorio (39,19%) y el promedio de permanencia fue de 4,29 ± 6,59. El SCP fue aplicado 166 veces y predominó el cuidado intensivo (69,28%), seguido por el semi-intensivo (13,86%) y el de alta dependencia (11,45%). Conclusión: Se constató un elevado número de cuidados intensivos y semi-intensivos relacionados con la larga permanencia en el sector, lo que descaracteriza las unidades de emergencia como locales de estabilización. Esta caracterización proporciona bases científicas y fidedignas para la gestión hospitalaria y de personal de enfermería. Descriptores: Administración Hospitalaria; Asistencia al Paciente; Emergencias; Enfermería de Emergencia; Enfermería; Organización y Administración.

scholarly journals Infectious Disease Hospitalizations, New York City, 2001-2014

2020 ◽  
Vol 135 (5) ◽  
pp. 587-598
Author(s):  
Chaorui C. Huang ◽  
David E. Lucero ◽  
Sungwoo Lim ◽  
Yihong Zhao ◽  
Robert J. Arciuolo ◽  
...  
Keyword(s):  
Infectious Disease ◽  
New York ◽  
New York City ◽  
York City ◽  
Lower Respiratory Tract ◽  
Hospitalization Rate ◽  
Hospital Death ◽  
Discharge Data ◽  
Hospitalization Rates ◽  
The Mean

Objective Hospital discharge data are a means of monitoring infectious diseases in a population. We investigated rates of infectious disease hospitalizations in New York City. Methods We analyzed data for residents discharged from New York State hospitals with a principal diagnosis of an infectious disease during 2001-2014 by using the Statewide Planning and Research Cooperative System. We calculated annual age-adjusted hospitalization rates and the percentage of hospitalizations in which in-hospital death occurred. We examined diagnoses by site of infection or sepsis and by pathogen type. Results During 2001-2014, the mean annual age-adjusted rate of infectious disease hospitalizations in New York City was 1661.6 (95% CI, 1659.2-1663.9) per 100 000 population; the mean annual age-adjusted hospitalization rate decreased from 2001-2003 to 2012-2014 (rate ratio = 0.9; 95% CI, 0.9-0.9). The percentage of in-hospital death during 2001-2014 was 5.9%. The diagnoses with the highest mean annual age-adjusted hospitalization rates among all sites of infection and sepsis diagnoses were the lower respiratory tract, followed by sepsis. From 2001-2003 to 2012-2014, the mean annual age-adjusted hospitalization rate per 100 000 population for HIV decreased from 123.1 (95% CI, 121.7-124.5) to 40.0 (95% CI, 39.2-40.7) and for tuberculosis decreased from 10.2 (95% CI, 9.8-10.6) to 4.6 (95% CI, 4.4-4.9). Conclusions Although hospital discharge data are subject to limitations, particularly for tracking sepsis, lower respiratory tract infections and sepsis are important causes of infectious disease hospitalizations in New York City. Hospitalizations for HIV infection and tuberculosis appear to be declining.

scholarly journals Determinants of Prolonged Length of Hospital Stay of Patients with Atrial Fibrillation

2021 ◽  
Vol 10 (16) ◽  
pp. 3715
Author(s):  
Ancuța Elena Vîjan ◽  
Ioana Cristina Daha ◽  
Caterina Delcea ◽  
Gheorghe-Andrei Dan
Keyword(s):  
Atrial Fibrillation ◽  
Hospital Stay ◽  
Multivariable Analysis ◽  
Length Of Hospital Stay ◽  
Limited Data ◽  
Reduced Ejection Fraction ◽  
Prolonged Length ◽  
Hospitalization Rates ◽  
Coronary Syndromes ◽  
The Mean

Background and Aim: The increasing prevalence and high hospitalization rates make atrial fibrillation (AF) a significant healthcare strain. However, there are limited data regarding the length of hospital stay (LOS) of AF patients. Our purpose was to determine the main drivers of extended LOS of AF patients. Methods: All AF patients, hospitalized consecutively in a tertiary cardiology center, from January 2018 to February 2020 were included in this retrospective cohort study. Readmissions were excluded. Prolonged LOS was defined as more than seven days (the upper limit of the third quartile). Results: Our study included 949 AF patients, 52.9% females. The mean age was 72.5 ± 10.3 years. The median LOS was 4 days. A total of 28.7% had an extended LOS. Further, 82.9% patients had heart failure (HF). In multivariable analysis, the independent predictors of extended LOS were: acute coronary syndromes (ACS) (HR 4.60, 95% CI 1.66–12.69), infections (HR 2.61, 95% CI 1.44–3.23), NT-proBNP > 1986 ng/mL (HR 1.96, 95% CI 1.37–2.82), acute decompensated HF (ADHF) (HR 1.76, 95% CI 1.23–2.51), HF with reduced ejection fraction (HFrEF) (HR 1.69, 95% CI 1.15–2.47) and the HAS-BLED score (HR 1.42, 95% CI 1.14–1.78). Conclusion: ACS, ADHF, HFrEF, increased NT-proBNP levels, infections and elevated HAS-BLED were independent predictors of extended LOS, while specific clinical or therapeutical AF characteristics were not.

Pilonidal Sinus: How to Choose Between Excision and Open Granulation Versus Excision and Primary Closure?

Swiss Surgery ◽  
2002 ◽  
Vol 8 (6) ◽  
pp. 255-258 ◽  
Author(s):  
Perruchoud ◽  
Vuilleumier ◽  
Givel
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Healing Time ◽  
Incision And Drainage ◽  
The Mean ◽  
Primary Healing

Aims: The purpose of this study was to evaluate excision and open granulation versus excision and primary closure as treatments for pilonidal sinus. Subjects and methods: We evaluated a group of 141 patients operated on for a pilonidal sinus between 1991 and 1995. Ninety patients were treated by excision and open granulation, 34 patients by excision and primary closure and 17 patients by incision and drainage, as a unique treatment of an infected pilonidal sinus. Results: The first group, receiving treatment of excision and open granulation, experienced the following outcomes: average length of hospital stay, four days; average healing time; 72 days; average number of post-operative ambulatory visits, 40; average off-work delay, 38 days; and average follow-up time, 43 months. There were five recurrences (6%) in this group during the follow-up period. For the second group treated by excision and primary closure, the corresponding outcome measurements were as follows: average length of hospital stay, four days; average healing time, 23 days; primary healing failure rate, 9%; average number of post-operative ambulatory visits, 6; average off-work delay, 21 days. The average follow-up time was 34 months, and two recurrences (6%) were observed during the follow-up period. In the third group, seventeen patients benefited from an incision and drainage as unique treatment. The mean follow-up was 37 months. Five recurrences (29%) were noticed, requiring a new operation in all the cases. Discussion and conclusion: This series of 141 patients is too limited to permit final conclusions to be drawn concerning significant advantages of one form of treatment compared to the other. Nevertheless, primary closure offers the advantages of quicker healing time, fewer post-operative visits and shorter time off work. When a primary closure can be carried out, it should be routinely considered for socio-economical and comfort reasons.

HYPEROESTROGENISMUS AND RHEUMATOID ARTHRITIS

1960 ◽  
Vol XXXIV (I) ◽  
pp. 45-50 ◽  
Author(s):  
J. L. Kalliomäki ◽  
Lauri Rauramo
Keyword(s):  
Rheumatoid Arthritis ◽  
Cervical Cancer ◽  
Urine Samples ◽  
Menstrual Bleeding ◽  
Menstrual Phase ◽  
Joint Symptoms ◽  
The Mean

ABSTRACT The authors have endeavoured to clarify the frequency of the hyperoestrogenismus syndrome in women with rheumatoid arthritis, aged 17–38 years, by means of clinical and cytologic studies, and by hormonal analyses. The material comprises 32 patients. Of these, 30 were suitable for cytologic observation. In 5 (17 %) of these 30 patients, the hyperoestrogenismus syndrome (17 %) may be considered definitely established. Aggravation of the joint symptoms in the pre-menstrual phase was reported by 41 % of the patients. Values for excretion of oestrogen exceeding 200 mouse units/24 hours were noted one week before menstrual bleeding in 8 of 19 women; the mean for oestrogen excretion was 268 mouse units/24 hours. Gonadotrophins were studied in the same urine samples, and the mean excretion was 22 mouse units/24 hours (range 7–65 m. u.). The excretion mean for 17-ketosteroids, simultaneously studied, was 9.1 mg/24 hours (range 2.3–18.0 mg). Side-finding in the material were made: incipient cervical cancer in one patient, ovarial tumour in one, and trichomoniasis in seven.

Effect of Surgical Versus Pharmacological Decompression of Ludwig’s Angina on Airway Compromise among Nigerian Patients

2020 ◽  
Author(s):  
Ekaniyere EB
Keyword(s):  
Length Of Hospital Stay ◽  
Surgical Decompression ◽  
Airway Compromise ◽  
Inclusion Criteria ◽  
Hospital Stays ◽  
Ludwig’S Angina ◽  
The Mean ◽  
The University ◽  
Ludwig's Angina ◽  
Gender Type

Background: Even though the decompression of the cellulitis phase of Ludwig’s angina (LA) by surgical or pharmacological approach is well documented, it is unclear which approach is more effective. Objective: We aim to compare the outcome of treatment between surgical versus pharmacological decompression in patients with LA. Subjects and Methods: A retrospective cohort study was designed. Data were collected from the case notes of patients that met the inclusion criteria from 2004 to 2018 at the University of Benin Teaching Hospital, Nigeria.The data were age, gender, type of decompression approach, length of hospital stay (LOS) and airway compromise. Result: A total of 62 patients comprising 37(59.7%) surgical decompression group and 25(40.3%) pharmacological decompression group were studied. Thirty-six (58.1%) males and 26 (41.9%) females were studied. Their mean age and standard deviation were 40.6 years and 11.9 years respectively. The mean length of hospital stays between the pharmacological and surgical decompression groups were 8.05 days and 13.8 days respectively. The incidence of airway compromise in the surgical decompression group was 19.9% lower than that of the pharmacological decompression group (P=0.47), which was not significant. The type of decompression approach also failed to influence the incidence of airway compromise (P = 0.41). Conclusion: The use of surgical versus pharmacological decompression does not significantly alter the incidence of airway compromise in the management of LA. The Patients that had surgical decompression had a shorter stay in the hospital as compared to those who had pharmacological decompression. This was not statistically significant.

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