scholarly journals Hospital Outcomes in Uninsured Patients With Disease and Disorders of Nervous System: A National Cohort Study During a Decade in the United States

Cureus ◽  
2021 ◽  
Author(s):  
Ali Seifi ◽  
Maryam Bahadori ◽  
Zahra Gheibi ◽  
Skyler L Kanegi ◽  
Alireza Mirahmadizadeh
Keyword(s):  
United States ◽  
Nervous System ◽  
Cohort Study ◽  
The United States ◽  
Uninsured Patients ◽  
Hospital Outcomes ◽  
System A ◽  
National Cohort ◽  
Disease And Disorders

Abstract 154: A Comparison of Carotid Artery Stent Placement Performed Within and Outside Clinical Trials in the United States

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Haitham M Hussein ◽  
Saqib A Chaudhry ◽  
Shahram Majidi ◽  
Rakesh Khatri ◽  
Gustavo J Rodriguez ◽  
...  
Keyword(s):  
United States ◽  
Clinical Trial ◽  
Clinical Trials ◽  
Hospital Mortality ◽  
Stent Placement ◽  
The United States ◽  
Cardiac Events ◽  
Hospital Outcomes ◽  
End Point ◽  
National Cohort

Background: A discrepancy between characteristics of patients treated with carotid angioplasty and stent placement (CAS) within and outside clinical trials, particularly characteristics with direct impact on clinical outcome, may lead to reduction in anticipated benefit. Objective: To identify differences in demographic and clinical characteristics and outcomes related to CAS in patients treated within clinical trials and those treated outside clinical trials in a large national cohort. Methods: We determined the frequency of CAS performed within and outside clinical trials and associated in-hospital outcomes using data from the Nationwide Inpatient Survey (NIS) data files from 2005 to 2008. All the in-hospital outcomes were analyzed after adjusting for potential confounders using multivariate analysis. Results: Of the 47,899 patients who underwent CAS, 16,078 (1%) underwent the procedure as part of a clinical trial. The mean age of the patients was significantly lower in patients treated with CAS as part of a clinical trial than those treated with CAS outside a clinical trial. The proportion of women and non-whites was lower among patients treated with CAS as part of a clinical trial. The in-hospital mortality was two folds higher among patients treated with CAS outside clinical trial (1.12% versus 0.53%, p=0.0.0005). The rate of composite end-point of stroke, cardiac events, and death was significantly higher among patients treated with CAS outside clinical trials (p=0.02). After adjusting for age, gender, presence of hypertension, diabetes mellitus, renal failure, congestive heart failure, and hospital teaching status, CAS performed as part of clinical trial was associated with lower rates of in-hospital mortality (OR 0.349, 95% CI 0.219-0.555)(p<0.0001) and composite end point of stroke, cardiac events, and death (OR 0.349, 95% CI 0.219-0.555)(p<0.0001) . Conclusions: Our results suggests that CAS performed as part of clinical trial was associated with lower rates of in-hospital mortality and composite end point of stroke, cardiac events, and death in United States. These findings highlight the need for strategies that ensure appropriate adoption of CAS to ensure that the benefits observed in clinical trials can be replicated in general practice.

Pediatric heart‐liver transplant outcomes in the United States: A 25‐year National Cohort Study

2021 ◽  
Author(s):  
Swati Choudhry ◽  
William J. Dreyer ◽  
Kyle D. Hope ◽  
Yunfei Wang ◽  
Joseph A. Spinner ◽  
...  
Keyword(s):  
United States ◽  
Cohort Study ◽  
Liver Transplant ◽  
The United States ◽  
Transplant Outcomes ◽  
National Cohort

scholarly journals Covid-19 by Race and Ethnicity: A National Cohort Study of 6 Million United States Veterans

2020 ◽  
Author(s):  
Christopher T. Rentsch ◽  
Farah Kidwai-Khan ◽  
Janet P. Tate ◽  
Lesley S. Park ◽  
Joseph T. King ◽  
...  
Keyword(s):  
United States ◽  
Cohort Study ◽  
Race And Ethnicity ◽  
Ethnic Disparities ◽  
The United States ◽  
United States Department ◽  
Department Of Veterans Affairs ◽  
Wide Range ◽  
National Cohort ◽  
Race Ethnicity

Background: There is growing concern that racial and ethnic minority communities around the world are experiencing a disproportionate burden of morbidity and mortality from symptomatic SARS-Cov-2 infection or coronavirus disease 2019 (Covid-19). Most studies investigating racial and ethnic disparities to date have focused on hospitalized patients or have not characterized who received testing or those who tested positive for Covid-19. Objective: To compare patterns of testing and test results for coronavirus 2019 (Covid-19) and subsequent mortality by race and ethnicity in the largest integrated healthcare system in the United States. Design: Retrospective cohort study. Setting: United States Department of Veterans Affairs (VA). Participants: 5,834,543 individuals in care, among whom 62,098 were tested and 5,630 tested positive for Covid-19 between February 8 and May 4, 2020. Exposures: Self-reported race/ethnicity. Main outcome measures: We evaluated associations between race/ethnicity and receipt of Covid-19 testing, a positive test result, and 30-day mortality, accounting for a wide range of demographic and clinical risk factors including comorbid conditions, site of care, and urban versus rural residence. Results: Among all individuals in care, 74% were non-Hispanic white (white), 19% non-Hispanic black (black), and 7% Hispanic. Compared with white individuals, black and Hispanic individuals were more likely to be tested for Covid-19 (tests per 1000: white=9.0, [95% CI 8.9 to 9.1]; black=16.4, [16.2 to 16.7]; and Hispanic=12.2, [11.9 to 12.5]). While individuals from minority backgrounds were more likely to test positive (black vs white: OR 1.96, 95% CI 1.81 to 2.12; Hispanic vs white: OR 1.73, 95% CI 1.53 to 1.96), 30-day mortality did not differ by race/ethnicity (black vs white: OR 0.93, 95% CI 0.64 to 1.33; Hispanic vs white: OR 1.07, 95% CI 0.61 to 1.87). Conclusions: Black and Hispanic individuals are experiencing an excess burden of Covid-19 not entirely explained by underlying medical conditions or where they live or receive care. While there was no observed difference in mortality by race or ethnicity, our findings may underestimate risk in the broader US population as health disparities tend to be reduced in VA.

scholarly journals Burden of non-alcoholic steatohepatitis among children with type 2 diabetes mellitus

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Lauren Parlett ◽  
Qinli Ma ◽  
Qian Shi ◽  
Geoffrey Crawford ◽  
Laura Herrera Scott ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
United States ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cohort Study ◽  
Retrospective Cohort ◽  
The United States ◽  
Alcoholic Steatohepatitis ◽  
Diabetic Children

AbstractThis claims-based retrospective cohort study examined the prevalence and incremental impact of non-alcoholic steatohepatitis among children with type 2 diabetes mellitus in the United States. Although diagnoses of non-alcoholic steatohepatitis were not common among diabetic children, it was associated with significantly higher incremental healthcare cost and risk of hospitalization.

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