Nationwide Inpatient Sample Study Research Articles

S134 Septic Shock and Acute Kidney Injury Are Predictors of In-Hospital Mortality Among Prediabetic Pancreatic Cancer Patients: A Nationwide Inpatient Sample Study

S134 Septic Shock and Acute Kidney Injury Are Predictors of In-Hospital Mortality Among Prediabetic Pancreatic Cancer Patients: A Nationwide Inpatient Sample Study

S783 Does Race Affect Gastrointestinal Bleeding Outcome in Atrial Fibrillation Patients on Oral Anticoagulation Therapy: Nationwide Inpatient Sample Study

S783 Does Race Affect Gastrointestinal Bleeding Outcome in Atrial Fibrillation Patients on Oral Anticoagulation Therapy: Nationwide Inpatient Sample Study

HTRS2023.P4.1 Effect of heparin induced thrombocytopenia on outcomes of pulmonary embolism: a nationwide inpatient sample study

HTRS2023.P4.1 Effect of heparin induced thrombocytopenia on outcomes of pulmonary embolism: a nationwide inpatient sample study

S52 African Americans With Pancreatic Adenocarcinoma Have Higher Inpatient Mortality at a Younger Age: A Nationwide Inpatient Sample Study

S52 African Americans With Pancreatic Adenocarcinoma Have Higher Inpatient Mortality at a Younger Age: A Nationwide Inpatient Sample Study

Ostomy Surgery for Patients with Large Bowel Obstruction in the Modern Era: a Nationwide Inpatient Sample Study

Ostomy Surgery for Patients with Large Bowel Obstruction in the Modern Era: a Nationwide Inpatient Sample Study

Demographic and Clinical Correlates of Narcolepsy in Adolescents Hospitalized with Mood Disorders: A Nationwide Inpatient Sample (NIS) Study

ABSTRACT Objectives To discern the differences in demographic, clinical comorbidities, and hospital outcomes associated with narcolepsy in adolescents hospitalized for mood disorders. Methods We included 639,064 adolescents hospitalized with mood disorders, that is, major depressive disorder (MDD) and bipolar disorders (BP) from the nationwide inpatient sample. About 0.04% of inpatients had comorbid narcolepsy (N = 267) and we extracted a demographically matched control group (N = 270) for comparison. Results Mood-disordered adolescents with narcolepsy had a higher prevalence of comorbid obesity (18.5% in BP,14.4% in MDD) and sleep apnea (9.3% in BP, 9.6% in MDD) compared to those without narcolepsy. Obesity and sleep apnea were significantly more prevalent in Black adolescents hospitalized for MDD and BP (P < .001). There was a higher percentage of females with BP and comorbid narcolepsy than males (59.9% vs 40.1%). In comparison, MDD and comorbid narcolepsy were observed more in males (57.1% vs 42.9%). Conclusions Our study results suggest a significantly higher prevalence of obesity and sleep apnea comorbidity in mood-disordered adolescents with narcolepsy with an overall negative impact on hospital outcomes.

Outcomes of pulmonary embolism in patients with pancreatic cancer: A nationwide inpatient sample study.

e16235 Background: Pancreatic cancer is considered one of the most aggressive cancers with five-year relative survival of 10.8% as per the national institute of health (NIH); Thromboembolism is a well-known complication of pancreatic cancer which contributes to increased morbidity, mortality and burden on the health care system. We attempted to evaluate the outcomes of pulmonary embolism in patients with pancreatic cancer. Methods: Healthcare Cost and Utilization Project National Inpatient Sample (HCUP-NIS) was queried to identify Pulmonary embolism admissions between 2016-2018 In Adult patients with diagnosis of pancreatic cancer using International Classification of Disease 10th Revision (ICD-10) codes. We evaluated mortality, Need for ventilation, Tissue plasminogen activator (TPA) administration, Embolectomy, Inferior vena cava (IVC) filter insertion and Acute kidney injury. Secondary outcomes included mean length of stay (LOS) and the mean cost of hospitalization. Results: A total 5335 admissions with PE and Pancreatic cancer were identified; in the baseline characteristics mean age was 67.4 at time of diagnosis with 51% being females and the white race constituted 73% of the total admissions. 385 patients (7%) died during hospitalization,165 patients (3%) required ventilation, 140 patients (2.6%) had TPA administration,560 patient (10.4%) had IVC inserted, 640 patients (12%) developed Acute kidney injury, and none had embolectomy. Mean length of stay was around 5 days and the mean cost of hospitalization was $12405. Conclusions: Pulmonary embolism increases mortality among patients with Pancreatic cancer; in addition to its effect on morbidity and burden on health care system; Efforts should be made to identify those with pancreatic cancer and considered high risk for Venous thromboembolism who may benefit from primary prophylaxis.

Impact of venous thromboembolism in hospitalized patients with pancreatic cancer: A nationwide inpatient sample (NIS) study.

535 Background: Pancreatic cancer (PC) has a strong association with venous thromboembolism (VTE) but the impact of it on mortality and morbidity is unknown. Inpatient costs contribute significantly to the overall cancer care costs even though there is a modest improvement in survival of pancreatic cancer patients. This study aims to determine the mortality trends and associated health care utilization in PC patients with and without VTE and to analyze its impact on hospitalized patients. Methods: We used National Inpatient Sample (NIS) to extract data for all patients above 18years of age hospitalized with a primary diagnosis of Pancreatic cancer from 2002-2018 using ICD-9 and ICD-10 codes. Unadjusted odds ratio for dichotomous outcomes were calculated, and independent t test analysis was done for continuous outcomes. Results: The odds of all-cause mortality (OR 1.35, 95% CI 1.33-1.37, p&lt;0.001) and stroke (OR 1.82, 95% CI, 1.76-1.87, p&lt;0.001) were significantly higher in pancreatic cancer patients with VTE compared to without VTE. PC patients with VTE were found to have significantly higher average cost of hospitalization (US $56101 vs US $46325, p&lt;0.001) and longer length of stay(LOS) (8.20 vs 6.83, p&lt;0.001) when compared to patients without VTE. Conclusions: Hospitalized PC patients with VTE have higher odds of mortality and stroke when compared to PC patients without VTE. Similarly, VTE in PC patients is shown to increase the hospitalization costs and overall length of stay.[Table: see text]

Comparison of Characteristics and Inpatient Outcomes of Patients With Inflammatory Bowel Disease and Colon Cancer: A Propensity-Based Nationwide Inpatient Sample Study.

IntroductionPatients with inflammatory bowel diseases (IBDs) frequently develop colon cancer. Previous studies have identified the association between IBD and colon cancer. In this study, we explored the characteristics and outcomes of IBD patients with colon cancer admitted to the hospitals of the United States.MethodsPatients who were hospitalized patients with diagnoses of IBD and colon cancer were compared with patients with IBD without colon cancer. The data were extracted from the Nationwide Inpatient Sample (NIS) from January 2016 to December 2017. Comparisons were made with regards to mortality, complications, in-hospital stay, and cost of treatment between the two groups.ResultsWe identified 1,82,025 hospitalizations from January 2016 to December 2017 admitted with a diagnosis of IBD. Of these, 181,560 patients had IBD without colon cancer, and 465 patients had IBD with colon cancer. No statistically significant difference was observed with regards to the in-hospital mortality between the two groups. There were higher odds of acute kidney injury (AKI) (OR 1.54, 95% CI 6.6-9.8; p=0.00), colectomy (OR 1.2, 95% CI 1.3-2.5; p=0.0) and lower gastrointestinal bleeding (LGIB) (OR 1.6, 95% CI 1.8-3.7; p=0.04) in patients with IBD and colon cancer. A longer length of stay (7.1±6.9 vs.5.0±5.6, p=0.00) and higher mean total charge ($20,283 vs. $12,166, p=0.00) were observed in patients with IBD with colon cancer.ConclusionsPatients with IBD-associated colon cancer appear to have higher complication rates, higher costs, and more extended hospital stays. Therefore, early identification and management of complications related to IBD among patients with colon cancer are particularly crucial to reduce morbidity as well as the cost of hospitalization and treatment.

S3321 The Effect of Concomitant Hepatitis B Infection and Inflammatory Bowel Disease on Mortality and Hospital Length of Stay: A Nationwide Inpatient Sample Study

S3321 The Effect of Concomitant Hepatitis B Infection and Inflammatory Bowel Disease on Mortality and Hospital Length of Stay: A Nationwide Inpatient Sample Study

Colonic Stent Use by Indication and Patient Outcomes: A Nationwide Inpatient Sample Study

Colonic stent placement can avoid urgent surgery for large bowel obstruction in selected patients. Population-wide stent utilization patterns and outcomes are unknown. Using retrospective, population-based, Nationwide Inpatient Sample data, we studied patients with colonic stents discharged during 2010-2015. The primary outcome was ostomy creation during the same hospitalization. Other outcomes were perforation or peritonitis, and in-hospital death. Associations of outcomes with stent indication were investigated, adjusting for patient-, admission-, and hospital characteristics. We estimated annual population-wide stent use volumes. Of 4257 patients with stent placement (52% male, mean age 64.6 years), 9.9% had non-metastatic colon cancer, 12.9% metastatic colon cancer, 37.8% extracolonic malignancy (ECM), and 39.3% had benign obstruction. In 8.1% of patients, ostomy creation surgery was performed. Perforation or peritonitis occurred in 16.7%, and in-hospital death in 4.5%. Relative to ECM, ostomy creation was several-fold more likely among nonmetastatic colon cancer (adjusted odds ratio (OR) 3.4; 95%CI, 2.1-5.5), metastatic colon cancer (adjusted OR 2.5; 95%CI, 1.7-3.7), and benign obstruction patients (adjusted OR 3.1; 95%CI, 2.1-4.7). Benign obstruction was associated with high risk of perforation/peritonitis (adjusted OR 3.1 relative to non-metastatic CC (95%CI, 2.1-4.5)). Perforation/peritonitis was highly associated with inpatient death (adjusted OR 6.8 (95%CI, 4.9-9.5)). Annually, about 3,580 patients underwent stent placement, with benign obstruction showing an increasing trend (P=0.0002). Over 75% of stent placements were done for patients with benign disease and ECM obstruction. Subsequent ostomy creation during the hospitalization was least likely among ECM patients. Rates of perforation/peritonitis in benign obstructions were concerningly high. (22.2%).

Outcomes of Open, Laparoscopic, and Percutaneous Drainage of Infected Walled-Off Pancreatic Necrosis: A Nationwide Inpatient Sample Study.

BackgroundWalled-off pancreatic necrosis (WOPN) represents an encapsulated collection of necrotic pancreatic or peripancreatic tissue that tends to develop four weeks after the onset of acute necrotizing pancreatitis. When infected, it is managed initially by antibiotic therapy before drainage by endoscopic, percutaneous, or surgical means. This study aims to describe the morbidity, mortality, length of stay (LOS), and cost of care associated with open surgical, laparoscopic, and radiology-guided percutaneous drainage in adult patients with infected WOPN.MethodsUsing the Nationwide Inpatient Sample (NIS), patients aged 18 years and older discharged with the diagnosis of WOPN between January 1, 2016 and December 31, 2016 who underwent open, laparoscopic, or percutaneous drainage were included. Patients’ characteristics including age, gender, and body mass index were reported. The primary endpoints were the mortality rate as well as length and cost of stay in each group. The secondary endpoint was the rate of procedural complications in each arm. Endpoints were reported and compared with studies assessing similar outcomes. Statistical Analysis System (SAS) statistical software (SAS Institute Inc., Cary, NC, USA) was used to perform the analysis.ResultsA total of 229 patients with the diagnosis of acute pancreatitis with infected necrosis were identified. Of these 229 patients, 27, 15, and 20 underwent open, laparoscopic, and percutaneous drainage, respectively. A total of eight studies were used for comparison of outcome variables. Mortality rate was found to be similar among comparison studies. LOS and costs varied widely among studies. There were significantly fewer pancreatic fistula and significantly more multi-organ failure complications as a result of open necrosectomy in the NIS study sample.ConclusionOverall, in analyzing the outcomes of patients undergoing intervention for infected WOPN through the 2016 NIS database, it appears that the database is representative of the majority of outcomes seen in similar clinical trials.

Outcomes Associated With Infection of Chronic Pain Spinal Implantable Electronic Devices: Insights From a Nationwide Inpatient Sample Study

ObjectivesChronic pain spinal implantable electronic devices (CPSIEDs) include devices that provide spinal cord stimulation and intrathecal drug therapy. In this study, we sought to evaluate the trends of CPSIED infections, related complications, and outcomes following the treatment of infection. Materials and MethodsThe Nationwide Inpatient Sample database contains data from 48 states, and the District of Columbia was used to identify patients with a primary diagnosis of CPSIED infection during the years 2005–2014. Patients with intrathecal pumps for the treatment of spasticity were excluded to limit the study population to patients with chronic pain disorders. Treatments were categorized as: 1) without device removal, 2) pulse generator or pump only removal, 3) intrathecal pump system removal, and 4) spinal cord stimulation system removal. Complications associated with CPSIED infections were identified using administrative billing codes. ResultsDuring the study period 2005–2014, a total of 11,041 patients were admitted to the hospital with CPSIED infections. The majority of the patients were treated without surgical intervention (56%), and a smaller proportion underwent complete system explantation (22.7%). In-hospital mortality or permanent disability due to paralysis after CPSIED infection was around 1.83% and 2.77%, respectively. Infectious complications such as meningitis, abscess formation, and osteomyelitis occurred in 4.93%, 5.08%, and 1.5%, respectively. The median cost of hospitalization was around US $14,118.00, and the median length of stay was approximately six days (interquartile range = 4–13 days). ConclusionsThe complications of CPSIED infection were higher among patients that did not undergo device removal.

S1173 Impact of Diabetes Mellitus on Hospital Admissions Due to Pyogenic Liver Abscess, a Nationwide Inpatient Sample Study

S1173 Impact of Diabetes Mellitus on Hospital Admissions Due to Pyogenic Liver Abscess, a Nationwide Inpatient Sample Study

S0706 The Outcome of Inflammatory Bowel Disease in Patients With Colon Cancer: A Propensity-Based Nationwide Inpatient Sample Study

S0706 The Outcome of Inflammatory Bowel Disease in Patients With Colon Cancer: A Propensity-Based Nationwide Inpatient Sample Study

Trends in Hospitalization and Inpatient Outcomes of Behçet's Disease: A Nationwide Inpatient Sample Study.

ObjectiveAfter an extensive review of the literature, we discovered that no study had addressed trends in hospitalization for people with Behçet's disease (BD). Hence, in this study, we explore multiple variables in patients with BD in the US for the year 2016.MethodsWe analyzed the data relating to hospitalized patients for the year 2016 using the National Inpatient Sample (NIS) database with a listed discharge diagnosis of BD based on the International Classification of Diseases, 10th Revision (ICD-10) diagnosis code M35.2. The mean age in years, alive discharges, lumbar puncture procedures, type of hospital, the Charlson Comorbidity Index (CCI), comorbidities, mean length of stay (LOS) and factors affecting it, and total cost and charges for the admissions were analyzed. A p-value of <.05 was considered statistically significant.ResultsA total of 2,605 discharges with the diagnoses of BD were identified among 35.7 million overall discharges in 2016. Among patients hospitalized with underlying BD, the majority were white and female. The mean hospital LOS was 5.57 ± 0.37 days, which is higher than in the general population and statistically significant (5.57 days vs 4.62 days; p: 0.009). Mean LOS in patients undergoing lumbar puncture was 8.54 ± 2.91 days. Patients with BD had lower medical comorbidity burden (16.9% with a CCI of ≥3) vs the general population (24.67% with a CCI of ≥3) (p: 0.00). Medical comorbidities with a statistically significant difference in their prevalence in the two groups were renal disease, dementia, peptic ulcer disease, heart failure, rheumatologic disorders, malignancy, and dyslipidemia.ConclusionIncreased awareness about this rare condition in an inpatient setting will help in the early identification of the disease and associated complications. This will help caregivers to provide quality care in a timely manner, thereby decreasing the morbidity, mortality, LOS, and hospital costs associated with BD.

Emergent colectomy rates decreased while elective ileal pouch rates were stable over time: a nationwide inpatient sample study.

Despite advances in biologic therapy, approximately 10-15% of ulcerative colitis (UC) patients require surgery. We aimed to (1) examine the rates of emergent colectomy and elective ileal pouch anal anastomosis (IPAA) over time among UC patients in the USA and (2) investigate disparities in surgery rates by patient demographics. Data from the Nationwide Inpatient Sample (NIS) from 2000 to 2014 were analyzed. Inclusion criteria were admissions with a primary UC ICD-9-CM diagnosis code and age > 18. Emergent cases were defined as those admitted through the emergency room with an outcome ICD-9-CM code for subtotal colectomy. Elective IPAA cases were defined with an outcome ICD-9-CM code for IPAA, used as a surrogate measure of colectomy. Patient and hospital-level demographics were analyzed. Temporal trends of colectomy were analyzed utilizing joinpoint-regression analysis with calculation of annual percentage change (APC). A total of 470,708 admissions were included over the 14-year period. Emergent colectomy rate significantly declined (APC - 7.35%, p= 0.0002), while the rate of elective IPAA remained stable (APC - 0.21%, p= 0.8). Emergent colectomy rates declined similarly across all demographics, though not as marked among patients age 50 and older and Medicare patients. Elective IPAA rates were significantly lower among blacks and patients with public insurance. There has been a significant decline in emergent UC colectomy rates in the USA; however, the overall need for surgery appears unchanged given stable IPAA rates. This suggests a limited impact on overall surgery rates with a shift from emergent to elective procedures.

Trends in the epidemiology of pediatric acute and chronic cholecystitis-related admissions in the USA: a nationwide emergency department and inpatient sample study

Acute and chronic cholecystitis can be related to gallstone disease, although in childhood acalculous cholecystitis may be the most frequent form. Chronic acalculous cholecystitis is a subtype of pediatric chronic...

National Trends and Hospitalizations Related to Pancreatic Cancer in Acute Pancreatitis Patients: A Nationwide Inpatient Sample Study.

BackgroundPancreatic cancer (PC) is one of the common cancers in the United States (U.S.) and is associated with high mortality and morbidity. In spite of the modest improvement in survival, cancer care costs including PC continue to rise and inpatient costs contribute a significant chunk to cancer care, which is often ignored. Acute pancreatitis (AP) is a rare manifestation of PC. This study aims to determine the national trends and associated health care utilization of PC patients hospitalized with AP in the U.S.MethodsWe used National Inpatient Sample (NIS) to extract data for patients hospitalized with a primary diagnosis of PC in AP in 2016 using International Classification of Diseases, 10th revision, and Clinical Modification (ICD-10-CM) codes. The analysis included disease etiologies, age, race, sex, hospital region, hospital size, institution type, mortality, length of hospital stay (LOS), and commonly associated comorbidities were correlated.ResultsThere were 250 patients with a discharge diagnosis of PC in patients admitted with AP. Most of the patients were whites (76.6%) with the mean age of 39.42 ± 2.51 years, had Medicare (63.26%) as primary insurance, were from Southern region (46%) and had higher Charlson comorbidity index (CCI) (76.00% with CCI > = 3). The mean hospital charges were $48,462.13, and mean LOS was 5.24 days. The LOS was significantly impacted by race, hospital region, endoscopic retrograde cholangiopancreatography (ERCP), and comorbidities such as dementia, smoking, and seizure. Out of the 250 patients admitted with PC, 245 patients (98%) were discharged alive.ConclusionsOur study shows a downward trend in LOS, hospital charges, and in-hospital mortality as compared to other studies despite PC and AP presenting together versus PC with or without other etiologies.

Epidemiology, national trends and clinical associations of pancreatic adenocarcinoma in chronic pancreatitis patients: A nationwide inpatient sample (NIS) study.

e15737 Background: Chronic pancreatitis (CP) is a known risk factor for pancreatic adenocarcinoma (PA). The aim of this study was to evaluate epidemiology, national trends and clinical associations of PA in hospitalized US patients with CP using the NIS database. Methods: ICD-9 CM codes were used to identify patients with CP and PA between 2002-2014. Age, gender, race, mortality, length of stay (LOS) and commonly associated comorbidities were correlated. Statistical analysis was done using SPSS 25. Results: We identified 1,677,517 patients with CP between 2002-2014. Patients with concurrent PA comprised 1.3 % (21,832) of total patients with CP. During the study period, the prevalence of PA in CP patients remained nearly steady (1.2% in 2002 and 1.3% in 2014). Median LOS was 8 days and decreased from 10 days in 2002 to 6 days in 2014. Overall mortality was 3.5% during hospitalization with the trend of mortality not showing a significant change in the study period (4.2% in 2002 and 4.1% in 2014). Median cost of total hospitalization for CP with PA was 52,116 USD, almost three-folds higher than for CP alone (18,797 USD) and increased from 42,241 USD in 2002 to 55,525 USD in 2014. For patients with CP and PA, 87.5% were above 50-years-old; 55.6% were males; Caucasians and African-Americans represented 72.2% and 12.6% of patients respectively. Interestingly, factors less associated with PA in CP included alcohol (OR 0.27, 95% CI 0.26-0.29, P &lt; .0001), Diabetes Mellitus (DM) (OR 0.78, 95% CI 0.74-0.82, P &lt; 0.0001), Chronic hepatitis C (OR 0.56, 95%CI 0.48-0.66, P &lt; 0.0001) and pancreatic cysts and pseudocyst (OR 0.76, 95%, CI 0.69-0.83, P &lt; 0.0001). Tobacco use, metabolic syndrome, Chronic hepatitis B and H. Pylori infection were not statistically associated with PA. Conclusions: In hospitalized patients with CP, 1.3% had PA. During the study duration, trends of prevalence and mortality did not show significant change, median LOS decreased and hospitalization cost of charge increased. Risk factors for PA like alcohol, DM, chronic hepatitis C, and pancreatic cysts were less associated with PA in patients with CP. Future studies are needed for early detection of PA in patients with CP.