Hospitalization Expenses and Influencing Factors for Inpatients with Ischemic Heart Disease in Iran: A Retrospective Study

Background: Ischemic heart disease (IHD) is the leading cause of death and disability worldwide and in Iran, which imposes a heavy financial burden both on patient’s family and society. Objectives: This study aimed to analyze the direct medical costs of inpatients with IHD and its influencing factors in Iran in 2020. Methods: The sample of this cross-sectional study included 41,357 patients with IHD selected from the hospital information system (HIS) of the Iran Health Insurance Organization from August 23, 2019, to June 20, 2020. The study used the claims data of these patients, which included their demographics, length of stay (LOS), intensive care unit (ICU) admission, hospital accreditation grade, hospital ownership type, and patient discharge status. The multiple linear regression model was employed to evaluate the relationship between hospitalization costs and the associated factors. All statistical tests were conducted at the significance level of P < 0.05 using the R 3.6.3 software. Results: The mean age of patients was 63.95 ± 12.63 years old, and most of them were male (54.4%). The mean hospitalization cost per patient and per day was 586.42 ± 472.51 USD and 103.64 ± 100.29 USD, respectively. Moreover, the mean LOS was 4.92 days. Drugs and consumable medical supplies, as well as nursing and hoteling services, had the highest shares of hospitalization costs (29.54% and 29.4%, respectively). The hospitalization costs of patients with IHD were higher among men (β = 1.24), age 61 - 70 years (β = 1.38), LOS ≥ 5 (β = 2.92), ICU admission (β = 1.62), Iranian health fund (β = 1.21), and private hospitals (β = 1.91). Top-grade and first-grade hospitals had higher costs compared to grade 2 (β = 0.67), grade 3 (β = 0.35), and grade 4 (β = 0.72) hospitals. Deceased patients had also higher costs than patients with complete recovery (β = 0.63), relative recovery (β = 0.59), follow-up (β = 0.51), transfer to other medical centers (β = 0.44), and discharge against medical advice (DAMA) (β = 0.62). Conclusions: According to the results, shortening the LOS and controlling the high costs of drugs and consumable medical supplies are among the main strategies to reduce high hospitalization costs.

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Correlations Between Femoral Intima-media Thickness and Cardiovascular Risk Factors in Patients with Ischemic Heart Disease

Journal of Interdisciplinary Medicine ◽

10.1515/jim-2016-0007 ◽

2016 ◽

Vol 1 (1) ◽

pp. 32-36

Author(s):

Zsuzsanna Jeremiás ◽

Katalin Makó ◽

Norbert Szekeres ◽

Emese Rapolti ◽

Imre Benedek ◽

...

Keyword(s):

Heart Disease ◽

Cardiovascular Risk ◽

Ischemic Heart Disease ◽

Intima Media Thickness ◽

Left Ventricular ◽

Ischemic Heart ◽

Peripheral Vascular ◽

Posterior Tibial ◽

Media Thickness ◽

The Mean

Abstract Background: Atherosclerosis has a systemic impact, producing gradual stenoses of the main vessels, and many imaging techniques have been developed in order to detect and quantify the atherosclerotic lesions. Peripheral artery disease has been shown to be associated with the presence of coronary heart disease, at the same time with carotid artery involvement. The utility of the carotid artery intima-media thickness (IMT) in predicting cardiovascular events caused by atherosclerosis, led to the idea that assessing the femoral artery IMT could have a similar impact. Study aim: We sought to determine the correlations between the femoral IMT, the degree of left ventricular systolic dysfunction and cardiovascular risk factors in patients with established diagnosis of ischemic heart disease. Material and methods: We prospectively included 27 patients with diagnosed ischemic heart disease. The ankle-brachial index (ABI) was assessed for the anterior and posterior tibial arteries. The left ventricular ejection fraction (LVEF) was determined by echocardiography. The femoral IMT was measured by peripheral vascular ultrasound, at the common femoral artery, 1 cm proximally from the bifurcation. The patients were divided into 2 groups: Group 1 – patients with IMT<0.9mm, and Group 2: patients with IMT >0.9 mm. Results: The mean age of the study population was 65.52 ± 11.44 years, and 77.77% were males. The mean glycemia levels were 99.89 ± 30.34 mg/dl, total cholesterol: 176.81 ± 43.09 mg/dl and the mean triglyceride level 140 ± 65.12mg/dl. The mean LEVF was 49.98% ± 12.73%, and femoral IMT 0.75 mm ± 0.25 mm. IMT significantly correlated with cholesterol levels (R = 0.383, p = 0.048), anterior and posterior tibial artery pressures (R = 0.450, p = 0.018, R = 0.418, p = 0.029 respectively) and ABI (R = 0.623, p = 0.005). There was no significant correlation between the LVEF and the IMT (R = −0.143, p = 0.475). There was a significant difference between the 2 groups regarding the minimum anterior tibial artery pressure (95.57 mmHg vs. 63.5 mmHg, p = 0.0011) and the minimum ABI (0.85 vs. 0.5, p = 0.015), and the femoral IMT (p = 0.0001). For patients with a femoral IMT >0.9 mm, a significant correlation was found between ABI and femoral IMT (R = −0.710, p <0.0001). Conclusion: The femoral intima-media thickness, assessed with peripheral vascular ultrasound, could be a new marker in evaluating the global cardiovascular risk in patients with ischemic heart disease. Femoral IMT could become a new marker for systemic atherosclerosis.

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Predicting the outcome of COVID-19 infection in kidney transplant recipients

BMC Nephrology ◽

10.1186/s12882-021-02299-w ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Ozgur Akin Oto ◽

Savas Ozturk ◽

Kenan Turgutalp ◽

Mustafa Arici ◽

Nadir Alpay ◽

...

Keyword(s):

Heart Disease ◽

Ischemic Heart Disease ◽

Multivariable Analysis ◽

Graft Function ◽

Ischemic Heart ◽

Secondary Outcome ◽

Icu Admission ◽

Poor Graft Function ◽

Independent Risk Factors ◽

Age Over 60

Abstract Background We aimed to present the demographic characteristics, clinical presentation, and outcomes of our multicenter cohort of adult KTx recipients with COVID-19. Methods We conducted a multicenter, retrospective study using data of patients hospitalized for COVID-19 collected from 34 centers in Turkey. Demographic characteristics, clinical findings, laboratory parameters (hemogram, CRP, AST, ALT, LDH, and ferritin) at admission and follow-up, and treatment strategies were reviewed. Predictors of poor clinical outcomes were analyzed. The primary outcomes were in-hospital mortality and the need for ICU admission. The secondary outcome was composite in-hospital mortality and/or ICU admission. Results One hundred nine patients (male/female: 63/46, mean age: 48.4 ± 12.4 years) were included in the study. Acute kidney injury (AKI) developed in 46 (42.2%) patients, and 4 (3.7%) of the patients required renal replacement therapy (RRT). A total of 22 (20.2%) patients were admitted in the ICU, and 19 (17.4%) patients required invasive mechanical ventilation. 14 (12.8%) of the patients died. Patients who were admitted in the ICU were significantly older (age over 60 years) (38.1% vs 14.9%, p = 0.016). 23 (21.1%) patients reached to composite outcome and these patients were significantly older (age over 60 years) (39.1% vs. 13.9%; p = 0.004), and had lower serum albumin (3.4 g/dl [2.9–3.8] vs. 3.8 g/dl [3.5–4.1], p = 0.002), higher serum ferritin (679 μg/L [184–2260] vs. 331 μg/L [128–839], p = 0.048), and lower lymphocyte counts (700/μl [460–950] vs. 860 /μl [545–1385], p = 0.018). Multivariable analysis identified presence of ischemic heart disease and initial serum creatinine levels as independent risk factors for mortality, whereas age over 60 years and initial serum creatinine levels were independently associated with ICU admission. On analysis for predicting secondary outcome, age above 60 and initial lymphocyte count were found to be independent variables in multivariable analysis. Conclusion Over the age of 60, ischemic heart disease, lymphopenia, poor graft function were independent risk factors for severe COVID-19 in this patient group. Whereas presence of ischemic heart disease and poor graft function were independently associated with mortality.

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Frequency of Fibromyalgia in a Sample of Iraqi Patients in Mosul with Ischemic Heart Disease

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.7686 ◽

2021 ◽

Vol 9 (B) ◽

pp. 1672-1676

Author(s):

Ali Younis ◽

Mohammad Harith Alsaaty

Keyword(s):

Heart Disease ◽

Ischemic Heart Disease ◽

Multivariate Logistic Regression Analysis ◽

Left Ventricular ◽

Ischemic Heart ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

Ibn Sina ◽

American College Of Rheumatology ◽

The Mean

BACKGROUND: Fibromyalgia is a common chronic condition characterized by widespread musculoskeletal pain together with mood and cognitive dysfunction. Data on the frequency of fibromyalgia in ischemic heart disease (IHD) are scarce. AIM: This study aimed to assess the frequency of fibromyalgia in IHD patients and to evaluate the characteristics of IHD patients with comorbid fibromyalgia. METHODS: The study was conducted in the coronary care unit, Department of Medicine in Ibn Sina Teaching Hospital in Mosul city, between March and November 2020. One hundred patients with IHD and 100 healthy controls were studied. The diagnosis of fibromyalgia was according to the 2011 modification of the 2010 American College of Rheumatology preliminary diagnostic criteria for fibromyalgia. Socio-demographic features and IHD characteristics of patients were recorded. RESULTS: The frequency of fibromyalgia was significantly higher among patients with IHD (29%) as compared to controls (7%). The mean age and proportion of women were significantly higher in IHD patients with fibromyalgia than those without fibromyalgia. It was also more common in patients with the present MI (p = 0.032) and in patients who had previous coronary angiography (p = 0.008). Patients with comorbid fibromyalgia had lower left ventricular ejection fraction (LVEF) (p = 0.0003) and higher scores on beck depression inventory (p = 0.0025). However, on multivariate logistic regression analysis, only two variables remained significant, (1) among IHD patients, fibromyalgia was more frequent in women (odds ratio [OR] = 3.839, p = 0.022) and (2) in patients having lower LVEF (OR = 0.917, p = 0.008). CONCLUSION: There is a high frequency of fibromyalgia in patients with IHD. Those IHD patients with comorbid fibromyalgia are more likely to be older, women, and with poor LVEF.

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Estimation of Antioxidant Levels in Saliva and Serum of Chronic Periodontitis Patients with and without Ischemic Heart Disease

International Journal of Dentistry ◽

10.1155/2017/1965697 ◽

2017 ◽

Vol 2017 ◽

pp. 1-9 ◽

Cited By ~ 6

Author(s):

Anahita Punj ◽

Santhosh Shenoy ◽

N. Suchetha Kumari ◽

Priyanka Pampani

Keyword(s):

Superoxide Dismutase ◽

Heart Disease ◽

Glutathione Peroxidase ◽

Ischemic Heart Disease ◽

Antioxidant Capacity ◽

Chronic Periodontitis ◽

Ischemic Heart ◽

Healthy Controls ◽

Total Antioxidant ◽

The Mean

Objective. To investigate whether there is a relationship between periodontitis and ischemic heart disease by estimation of total antioxidant status in saliva and serum. Materials and Methods. A total of 80 samples were collected and divided equally into 4 groups of healthy controls, chronic periodontitis patients, ischemic heart disease patients with periodontitis, and ischemic heart disease patients without periodontitis. Saliva and venous blood samples were collected and analyzed for levels of total antioxidant capacity, superoxide dismutase, glutathione peroxidase, and catalase. Results. There were significant (p<0.05) differences in the mean serum levels of total antioxidant capacity (p<0.001), superoxide dismutase (p<0.001), glutathione peroxidase (p<0.006), and catalase (p<0.001) within the 4 groups, whereas the mean salivary levels were significant only for glutathione peroxidase (p=0.001). Both of these serum and salivary antioxidant levels were lower in disease groups of IHD + CP, IHD + H, and CP as compared to healthy controls, with different patterns. Conclusion. Antioxidant capacity is significantly hampered in chronic periodontitis and ischemic heart disease patients with or without periodontitis as compared to healthy controls. The salivary and serum antioxidants may not follow the same increase or decrease as a result of increased oxidant stress due to disease.

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