Economic burden of readmission due to postoperative cerebrospinal fluid leak in Chinese patients

Aim: This real-world data study investigated the economic burden and associated factors of readmissions for cerebrospinal fluid leakage (CSFL) post-cranial, transsphenoidal, or spinal index surgeries. Methods: Costs of CSFL readmissions and index hospitalizations during 2014–2018 were collected. Readmission cost was measured as absolute cost and as percentage of index hospitalization cost. Factors associated with readmission cost were explored using generalized linear models. Results: Readmission cost averaged US$2407–6106, 35–94% of index hospitalization cost. Pharmacy costs were the leading contributor. Generalized linear models showed transsphenoidal index surgery and surgical treatment for CSFL were associated with higher readmission costs. Conclusion: CSFL readmissions are a significant economic burden in China. Factors associated with higher readmission cost should be monitored.

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Sunburns among beachgoers in the northern coast of Peru: frequency and factors associated

PeerJ ◽

10.7717/peerj.11473 ◽

2021 ◽

Vol 9 ◽

pp. e11473

Author(s):

Eliana L. Fernandez-Quiroz ◽

Lizeth Gonzales-Chachapoyas ◽

Ana L. Alcantara-Diaz ◽

Binz Bulnes-Villalta ◽

Zulmy Ayala-Porras ◽

...

Keyword(s):

Generalized Linear Models ◽

Regression Models ◽

Linear Models ◽

Secondary Data ◽

Sun Exposure ◽

Prevalence Ratio ◽

Northern Coast ◽

Factors Associated ◽

Northern Peru ◽

Skin Phototype

Background Overexposure to ultraviolet (UV) radiation has increased skin cancer incidence and the risk of sunburns, especially during the summer months. Objective Identify the frequency and factors associated with sunburns in a sample of beachgoers in the northern coast of Peru. Methods We conducted a secondary data analysis of a previous study that assessed the awareness, behavior and attitudes concerning sun exposure among beachgoers. We included adults between 18 and 59 years who went to a beach in northern Peru during summer (March 2018). Three generalized linear models of the Poisson family were constructed to evaluate the factors associated with having had at least one sunburn last summer. All regression models reported the adjusted prevalence ratio (aPR) with their respective 95% confidence interval (95% CI). Results Of a total of 402 participants, 225 (56.0%) had one to five sunburns and 25 (6.2%) had six or more. Beachgoers who were 1–15 days (aPR: 1.16, 95% CI [1.05–1.27]) or more than 15 days (aPR: 1.22, 95% CI [1.09–1.36]) exposed to the sun on the beach had a higher frequency of at least one sunburn. The non-regular wearing of a hat or cap also increased the frequency of sunburns (aPR: 1.06, 95% CI [1.01–1.12]). In contrast, those who had Skin Phototype III (aPR: 0.94, 95% CI [0.88–0.99]) or IV (aPR: 0.69, 95% CI [0.63–0.75]) had a lower frequency of sunburns. Conclusion Three out of five beachgoers had one or more sunburns in the last summer. The factors associated with a higher frequency were the time of sun exposure at the beach and the non-regular use of a hat or cap. Type III–IV skin phototypes were associated with a lower sunburn frequency.

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Use of the translabyrinthine approach to repair congenital spontaneous cerebrospinal fluid leakage in five Chinese patients with Mondini dysplasia

International Journal of Pediatric Otorhinolaryngology ◽

10.1016/j.ijporl.2013.09.012 ◽

2013 ◽

Vol 77 (12) ◽

pp. 1965-1968 ◽

Cited By ~ 10

Author(s):

H.J. Yi ◽

H. Guo ◽

W. Ch ◽

S.M. Yang ◽

P.N. Liu

Keyword(s):

Cerebrospinal Fluid ◽

Chinese Patients ◽

Cerebrospinal Fluid Leakage ◽

Fluid Leakage ◽

Translabyrinthine Approach ◽

Mondini Dysplasia

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Clinical Factors Associated with Cutaneous Cerebrospinal Fluid Leakage in Infants Who Underwent a Ventriculoperitoneal Shunt Surgery

Arquivos Brasileiros de Neurocirurgia Brazilian Neurosurgery ◽

10.1055/s-0035-1547380 ◽

2015 ◽

Vol 34 (01) ◽

pp. 007-012

Author(s):

Fábio Almeida ◽

Felipe Maluf ◽

Ivana Duval-Araujo ◽

Andrea Pinho

Keyword(s):

Cerebrospinal Fluid ◽

Ventriculoperitoneal Shunt ◽

Cerebrospinal Fluid Leakage ◽

Shunt Surgery ◽

Clinical Factors ◽

Factors Associated ◽

Fluid Leakage

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Is posttraumatic cerebrospinal fluid fistula a predictor of posttraumatic meningitis? A US Nationwide Inpatient Sample database study

Neurosurgical FOCUS ◽

10.3171/2012.5.focus1269 ◽

2012 ◽

Vol 32 (6) ◽

pp. E4 ◽

Cited By ~ 15

Author(s):

Ashish Sonig ◽

Jai Deep Thakur ◽

Prashant Chittiboina ◽

Imad Saeed Khan ◽

Anil Nanda

Keyword(s):

Cerebrospinal Fluid ◽

Head Injury ◽

Skull Base ◽

Nationwide Inpatient Sample ◽

Neurosurgical Procedures ◽

Csf Rhinorrhea ◽

Cerebrospinal Fluid Rhinorrhea ◽

Factors Associated ◽

Hospitalization Cost ◽

Neurosurgical Intervention

Object Various factors have been reported in literature to be associated with the development of posttraumatic meningitis. There is a paucity of data regarding skull fractures and facial fractures leading to CSF leaks and their association with the development of meningitis. The primary objective of this study was to analyze the US Nationwide Inpatient Sample (NIS) database to elucidate the factors associated with the development of posttraumatic meningitis. A secondary goal was to analyze the overall hospitalization cost related to posttraumatic meningitis and factors associated with that cost. Methods The NIS database was analyzed to identify patients admitted to hospitals with a diagnosis of head injury from 2005 through 2009. This data set was analyzed to assess the relationship of various clinical parameters that may affect the development of posttraumatic meningitis using binary logistic regression models. Additionally, the overall hospitalization cost for the head injury patients who did not undergo any neurosurgical intervention was further categorized into quartile groups, and a regression model was created to analyze various factors responsible for escalating the overall cost of the hospital stay. Results A total of 382,267 inpatient admissions for head injury were analyzed for the 2005–2009 period. Meningitis was reported in 0.2% of these cases (708 cases). Closed skull base fractures, open skull base fractures, cranial vault fractures, and maxillofacial fractures were reported in 20,524 (5.4%), 1089 (0.3%), 5064 (1.3%), and 88,649 (23.2%) patients, respectively. Among these patients with fractures, meningitis was noted in 0.17%, 0.18%, 0.05%, and 0.10% admissions, respectively. Cerebrospinal fluid rhinorrhea was reported in 453 head injury patients (0.1%) and CSF otorrhea in 582 (0.2%). Of the patients reported to have CSF rhinorrhea, 35 (7.7%) developed meningitis, whereas in the cohort with CSF otorrhea, 15 patients (2.6%) developed meningitis. Cerebrospinal fluid rhinorrhea (p < 0.001, OR 22.8, 95% CI 15.6–33.3), CSF otorrhea (p < 0.001, OR 9.2, 95% CI 5.2–16.09), and major neurosurgical procedures (p < 0.001, OR 5.6, 95% CI 4.8–6.5) were independent predictors of meningitis. Further, CSF rhinorrhea (p < 0.001, OR 2.0, 95% CI 1.6–2.7), CSF otorrhea (p < 0.001, OR 2.3, 95% CI 1.9–2.7), and posttraumatic meningitis (p < 0.001, OR 3.1, 95% CI 2.5–3.8) were independent factors responsible for escalating the cost of head injury in cases not requiring any major neurosurgical intervention. Conclusions Cerebrospinal fluid rhinorrhea and CSF otorrhea are independent predictors of posttraumatic meningitis. Furthermore, meningitis and CSF fistulas may independently lead to significantly increased cost of hospitalization in head injury patients not undergoing any major neurosurgical intervention.

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