Hospital Admissions Of Persons Research Articles

Comparing vagus nerve stimulation and resective surgery outcomes in patients with co-occurring autism and epilepsy to patients with epilepsy alone: A population-based study.

Autism and epilepsy commonly co-occur. Understanding trends in healthcare utilization and in-hospital outcomes amongst patients with autism and epilepsy can help optimize care and reduce costs. We compared hospital outcomes amongst patients with autism and epilepsy to those with epilepsy alone undergoing vagus nerve stimulation (VNS) and resective/disconnective surgery. Differences in discharge status, in-hospital mortality, mean length of stay (LOS), cost and surgical/medical complications were examined. Elective surgical admissions amongst patients with epilepsy alone and co-occurring autism and epilepsy were identified in the 2003-14 National Inpatient Sample (NIS) using previously validated ICD-9-CM case definitions. One patient with co-occurring epilepsy and autism was matched to three epilepsy patients for age, sex and (1) VNS and (2) resective/disconnective surgery. Multinomial logistic regressions were performed to examine the outcomes of interest. Data were collected on: (1) VNS-52 (mean age: 12.79 ± 1.03; 19.27% female) hospital admissions in persons with comorbid autism and epilepsy, 156 (mean age: 12.84 ± 0.71; 19.31% female) matched controls with epilepsy alone; (2) resective/disconnective surgery-113 (mean age: 12.99 ± 0.84; 24.55% female) with comorbid autism and epilepsy, 339 (mean age: 13.37 ± 0.68; 23.86% female) matched controls with epilepsy alone. Compared to patients with epilepsy alone, patients with autism and epilepsy who underwent either surgery showed no differences for in-hospital mortality, discharge status, mean LOS, hospitalization cost, and surgical/medical complications. Our study shows the feasibility and safety of epilepsy VNS and resective surgery in those with ASD do not differ with those with epilepsy alone, contrary to the prevalent safety concerns of epilepsy surgery in patients with ASD.

Characterizing Hospital Admissions in Persons with Parkinson’s Disease: 10-Year Retrospective Study of Administrative Data in Alberta, Canada (P10-11.015)

<h3>Objective:</h3> To characterize the landscape of province-wide hospital admissions in persons with Parkinson’s disease (PD) and inform future healthcare improvement in this population. <h3>Background:</h3> Persons with PD tend to have longer hospital stays and are more likely to suffer from adverse events. The province of Alberta, Canada has a single healthcare provider (Alberta Health Services), permitting collection of population-level data from all healthcare facilities. <h3>Design/Methods:</h3> We performed a population-based, retrospective cohort study using discharge abstract data for all persons admitted to hospital from 2011 through 2021, in Alberta. We extracted data from the Discharge Abstract Database (DAD), which contains ICD-10-CA coded diagnoses for all patients discharged from hospital. Hospitalizations with PD as both main and pre-admission comorbid diagnoses were identified using the ICD-10-CA G20 (PD) and F02.3 (Dementia in PD) codes. <h3>Results:</h3> A total of 17168 hospitalizations were identified during the study period. Mean age was 78 (SD 9 years), and 39% (6761) were female. Median length of hospital stay was 12 days (interquartile range 27). For most patients, the attending service was family practice/general practice (67%, 11496), followed by internal medicine (16%, 2763), orthopedics (6%, 959), psychiatry (3%, 504), and neurology (3%, 497). In-hospital adverse events occurred in 11% (1857) of admissions; 1% (122) were life-threatening. The outcome in 54% (9289) of admissions was discharge home, 24% (4099) long-term care, and 13% (2244) to rehab or other acute care facility. In-hospital mortality was 7% (1225). <h3>Conclusions:</h3> Our study describes the landscape of PD hospitalization in a Canadian context. The main admitting specialties are family practice and internal medicine, and over half of patients are discharged home. Future directions include further analysis of this data to understand predictors for adverse outcomes and guide care delivery improvement. <b>Disclosure:</b> Dr. Mahjoub has nothing to disclose. Dr. Peters has nothing to disclose.

Incipient dementia and avoidable hospital admission in persons with osteoarthritis

ObjectiveTo investigate the associations between incipient dementia (ID) and hospitalization for ambulatory care sensitive conditions (ACSCs) among people with osteoarthritis (OA) of the peripheral joints. MethodsAmong individuals aged 51–99 years residing in Skåne, Sweden, in 2009, we identified those with a doctor-diagnosed OA and no dementia during 1998–2009 (n ​= ​57,733). Treating ID as a time-varying exposure, we followed people from January 1, 2010 or their 60th birthday (whichever occurred last) until hospitalization for ACSCs, death, 100th birthday, relocation outside Skåne, or December 31, 2019 (whichever occurred first). Using age as time scale, we applied flexible parametric survival models, adjusted for confounders, to assess the associations between ID and hospitalization for ACSCs. ResultsThere were 58 and 33 hospitalizations for ACSCs per 1000 person-years among OA people with and without ID, respectively. The association between ID and hospitalization for any ACSCs was age-dependent with higher risk in ages<86 years and lower risks in older ages. Between ages 60 and 100 years, persons with ID had, on average, 5.8 (95% CI 0.9, 10.7), 1.6 (−2.6, 5.9) and 3.1 (2.3, 4.0) fewer hospital-free years for any, chronic and acute ACSCs, respectively, compared with persons without ID. ConclusionsAmong persons with OA, while ID was associated with increased risks of hospitalization for ACSCs in younger ages, it was associated with decreased risk in oldest ages. These results suggest the need for improvement in quality of ambulatory care including the continuity of care for people with OA having dementia.

Linked data analysis of learning disability health checks and emergency hospital admissions in the Kent Integrated Dataset

People with learning disabilities have higher rates of admitted patient care than the general population. This study explored emergency hospital admissions during 2018/19 in association with learning disability health check recording in general practice within the Kent Integrated Dataset during 2016/17 to 2018/19. Multiple logistic regression evaluated the odds of emergency hospital admission by sex, age, deprivation, residence, risk score, long-term conditions, severe health needs and health check. During 2018/19, one or more emergency hospital admissions were recorded for 10.9% of the 5,759 persons recorded with learning disability. There were lower odds of emergency hospital admission in persons having had learning disability health check in the past 3years even after adjustment. Comparison to nationally representative research suggests a consistent finding of benefit from learning disability health check on indicators of unplanned care use, supporting the view that learning disability health checks facilitate the addressing of key health needs.

Nonelective hospital admissions, discharge disposition, and health services utilization in epilepsy patients: A population‐based study

Identifying adverse outcomes and examining trends and causes of nonelective admissions among persons with epilepsy would be beneficial to optimize patient care and reduce health services utilization. We examined the association of epilepsy with discharge status, in-hospital mortality, length-of-stay, and charges. We also examined 10-year trends and causes of hospital admissions among those with and without epilepsy. Nonelective hospital admission in persons with epilepsy was identified in the 2005-2014 National Inpatient Sample (NIS) using a validated International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) case definition. The NIS is the largest US all-payer database including patient and hospital-level variables, and represents hospitalizations in the general population. Descriptive statistics on trends and causes of admissions and multivariable regression analysis summarizing the association of epilepsy with the outcomes of interest are presented. Of 4718178 nonelective admissions in 2014, 3.80% (n=179461) were in persons with epilepsy. Admissions in persons with epilepsy increased from 14636 to 179461 (P<.0001) between 2005 and 2014. As compared to persons without epilepsy, hospital admissions in persons with epilepsy had higher odds of transfer to other facilities (odds ratio [OR]=1.77, 95% confidence interval [CI]: 1.72-1.81, P<.0001), being discharged against medical advice (OR=1.48, 95% CI: 1.38-1.59, P<.0001), and incurring 4% greater total charges (P<.0001). Epilepsy, convulsions, pneumonia, mood disorders, cerebrovascular disease, and septicemia were the top causes for admissions in those with epilepsy. Future research should focus on designing targeted health care interventions that decrease the number of hospital admissions, reduce health services utilization, and increase the odds of discharge home in people with epilepsy.

Adverse Drug Reactions Related Hospital Admissions in Persons Aged 60 Years and over, The Netherlands, 1981–2007: Less Rapid Increase, Different Drugs

BackgroundEpidemiologic information on time trends of Adverse Drug Reactions (ADR) and ADR-related hospitalizations is scarce. Over time, pharmacotherapy has become increasingly complex. Because of raised awareness of ADR, a decrease in ADR might be expected. The aim of this study was to determine trends in ADR-related hospitalizations in the older Dutch population.Methodology and Principal FindingsSecular trend analysis of ADR-related hospital admissions in patients ≥60 years between 1981 and 2007, using the National Hospital Discharge Registry of the Netherlands. Numbers, age-specific and age-adjusted incidence rates (per 10,000 persons) of ADR-related hospital admissions were used as outcome measures in each year of the study. Between 1981 and 2007, ADR-related hospital admissions in persons ≥60 years increased by 143%. The overall standardized incidence rate increased from 23.3 to 38.3 per 10,000 older persons. The increase was larger in males than in females. Since 1997, the increase in incidence rates of ADR-related hospitalizations flattened (percentage annual change 0.65%), compared to the period 1981–1996 (percentage annual change 2.56%).Conclusion/SignificanceADR-related hospital admissions in older persons have shown a rapidly increasing trend in the Netherlands over the last three decades with a temporization since 1997. Although an encouraging flattening in the increasing trend of ADR-related admissions was found around 1997, the incidence is still rising, which warrants sustained attention to this problem.

Trends in Fall-Related Hospital Admissions in Older Persons in the Netherlands

Fall-related injuries, hospitalizations, and mortality among older persons represent a major public health problem. Owing to aging societies worldwide, a major impact on fall-related health care demand can be expected. We determined time trends in numbers and incidence of fall-related hospital admissions and in admission duration in older adults. Secular trend analysis of fall-related hospital admissions in the older Dutch population from 1981 through 2008, using the National Hospital Discharge Registry. All fall-related hospital admissions in persons 65 years or older were extracted from this database. Outcome measures were the numbers, and the age-specific and age-adjusted incidence rates (per 10,000 persons) of fall-related hospital admissions in each year of the study. From 1981 through 2008, fall-related hospital admissions increased by 137%. The annual age-adjusted incidence growth was 1.3% for men vs 0.7% for women (P < .001). The overall incidence rate increased from 87.7 to 141.2 per 10,000 persons (an increase of 61%). Age-specific incidence increased in all age groups, in both men and women, especially in the oldest old (>75 years). Although the incidence of fall-related hospital admissions increased, the total number of fall-related hospital days was reduced by 20% owing to a reduction in admission duration. In the Netherlands, numbers of fall-related hospital admissions among older persons increased drastically from 1981 through 2008. The increasing fall-related health care demand has been compensated for by a reduced admission duration. These figures demonstrate the need for implementation of falls prevention programs to control for increases of fall-related health care consumption.

Hantavirus prevalence in the IX Region of Chile.

An epidemiologic and seroprevalence survey was conducted (n=830) to assess proportion of persons exposed to hantavirus in IX Region Chile, which accounts for 25% of reported cases of hantavirus cardiopulmonary syndrome. This region has three geographic areas with different disease incidences and a high proportion of aboriginals. Serum samples were tested for immunoglobulin (Ig) G antibodies by enzyme-linked immunosorbent assay against Sin Nombre virus N antigen by strip immunoblot assay against Sin Nombre, Puumala, Río Mamoré, and Seoul N antigens. Samples from six patients were positive for IgG antibodies reactive with Andes virus; all patients lived in the Andes Mountains. Foresting was also associated with seropositivity; but not sex, age, race, rodent exposure, or farming activities. Exposure to hantavirus varies in different communities of IX Region. Absence of history of pneumonia or hospital admission in persons with specific IgG antibodies suggests that infection is clinically inapparent.