Analysis Of Registry Data Research Articles

Methodological approaches to the detection of occupational cancer on the example of the Center for Occupational Pathology of the Trans-Baikal Territory

Introduction. Occupational malignant neoplasms (OMN) in the structure of occupational pathology in our country for a long time occupy the last rank place, amounting to no more than 0.5%. In fact, in the Russian Federation, doctors detect from 20 to 40 cases of occupational cancer every year. The share of OMN in the structure of occupational diseases detected in the EEC countries is about 5% (up to 3,700 cases per year). The actual number of detected cases of occupational cancer in our country is several orders of magnitude lower than forecast estimates. The problem of incomplete detection of occupational cancer is quite multifaceted, largely due to the lack of vigilance of primary care doctors, the high probability of a long latent period of the disease, etc. The study aims to find possible causes of occupational cancer based on data on newly identified cases of OMN entered into the regional cancer registry. Materials and methods. The objects of the study were 1,359 primary cases of OMN, entered into the regional cancer registry on the basis of the Zabaikalsky regional oncological dispensary. Scientists have developed an algorithm of actions, on the basis of which they carried out the selection of cases, taking into account the localization of the disease, anamnestic information, age parameters. The authors identified cases with suspicion of the occupational nature of the disease, followed by a request for documents necessary to conduct an examination of the connection of the disease with working conditions. On the basis of the Center for Occupational Pathology of the Trans-Baikal Territory, specialists conducted a direct examination and summed up the final results. Results. The authors selected 49 patients from 1359 cases and, after an additional request for information on the professional path, work experience in comparison with the nosological form of OMN, identified 16 cases with suspected occupational disease, of which a causal relationship between the development of the disease and working conditions was established in 12 cases, including 4 cases in patients in the post-contact period. Limitations. The study is limited by the number of cancer cases provided for analysis. Conclusion. The data obtained indicate that, using the example of one subject of the federation, over 10 months of work on the targeted analysis of cancer registry data, the number of cases of occupational cancer was revealed, almost comparable to the number of similar diseases detected in a year in the whole country. Ethics. The conduct of the study did not require the conclusion of the Ethics committee.

Comparison of Traditional and Intensive Cardiac Rehabilitation on Dietary Behavior and Clinical Risk Factor Outcomes

Purpose: The objective of this study was to assess differences in dietary behavior and clinical risk factor outcomes and explore predictors of change among patients participating in traditional and Pritikin intensive cardiac rehabilitation (CR). Methods: This secondary analysis of cardiac registry data from 2015 to 2021 included patients participating in traditional CR (n = 420) or Pritikin intensive CR (n = 1005) at a single hospital site. Dietary behavior outcomes included the Rate Your Plate measure, while clinical risk factor outcomes included fasting lipids, blood pressure, anthropometrics, functional outcomes, and psychosocial assessment. Analysis of covariance examined a difference in Rate Your Plate scores between CR groups. Multivariate analysis of covariance was used to determine differences in clinical risk factor variables between CR groups. Predictors of change in dietary behavior and clinical risk factors were determined through multiple bivariate linear regression models within each CR group. Results: Both CR programs led to significant improvements though more change was observed among Pritikin intensive CR participants in dietary behavior, anthropometrics, and fasting lipids. Status as a current or recent smoker was not a significant predictor of dietary behavior. Male sex, status as a current or recent smoker, beta-blockers, and angiotensin-converting enzyme inhibitors prescribed were not significant predictors of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, or non–high-density lipoprotein cholesterol for traditional and Pritikin intensive CR groups. There were not significant predictors of blood pressure, body mass, or waist circumference. Conclusion: Although participation in either CR program yielded cardiometabolic benefits, Pritikin intensive CR patients exhibited significantly greater improvements in dietary behavior and clinical risk factors.

Cardio-renal syndromes in patients admitted with ST-elevation myocardial infarctions: Incidence and impact on renal and overall outcome

Abstract Background The importance of cardiorenal syndromes (CRS) in patients with heart failure has been shown in many studies. However, there is little data on the impact of a combination of heart failure and renal disease in patients with acute myocardial infarctions. Aim of the present study was to investigate, how often a combination of heart failure (HF) and kidney disease (KD) could be detected in patients with ST-elevation myocardial infarctions and to estimate its impact on outcome. Methods All patients from a German heart center, admitted with STEMI between 2006 and 2022 were analysed. CRS was defined as a combination of heart failure (HF: left ventricular ejection fraction (LV-EF<40%), HF) and kidney disease (KD: GFR at admission <60 ml/min). Patients were assigned in a 2x2 model: HF-/KD-, HF-/KD+, HF+/KD-, HF+/KD+. Outcome analysis was adjusted by confounders in a multivariate Cox-regression-model. Acute kidney injury (AKI) was calculated by AKIN-criteria (KDIGO) Results Of a total of 8276 STEMI-patients included in the study 5696(69%) had a preserved LV-EF and no KD (HF-/KD-), 1354 (16%) a preserved LV-EF and KD (HF-/KD+), 743 (9%) a reduced LV-EF and no KD (HF+/KD-) and 483 (6%) both a reduced LV-EF and KD (HF+/KD+, CRS-Group). In the CRS-group patients were on average older (74.2±12 yrs. vs. 60.8±13 yrs., p<0.01), more likely to be female (36.9% vs. 23.1% in the control group, p<0.01) and more likely to be diabetics (31.0% vs. 16.8% in the control group, p<0.01). CRS was associated with higher rates of cardiogenic shock (41.5% vs. 8.7% in the control group) and higher rates of subsequent AKI with a 18x higher risk to develop AKIN-3 with or without the need for renal replacement therapy (RRT), (table, upper part). In patients with CRS in 11% of patients a temporal RRT was necessary vs. 0.5% in controls. Furthermore, in CRS-patients in-hospital and 1 year-mortality-rates were markedly higher (table, lower part). When adjusting outcomes for confounders (age, gender, CS, diabetes, anterior STEMI, 3 VD) the detrimental effect of CRS on outcome remained: AKIN-3/RRT: OR 16.5, 95% CI 7.5-30.0, p<0.01, In-hospital-mortality: OR 14.2, 95% CI 7.8-21, p<0.01, 1-year-mortality: HR 10.5, 95% CI 7.5-14.1, p<0.01. Conclusions In this analysis of registry data, cardiorenal disease could be detected in 6% of STEMI-patients, with higher rates in women and in diabetics. Patients with cardiorenal disease showed a more than 18-fold higher risk of suffering severe renal failure during the index event and a 24-fold higher risk of in-hospital death. Patients with either heart failure or renal disease were situated between the CRS and control group with regard to outcome. These results underline the additive effects of cardiac and renal disease.Table:Event rates by HF and KD group

Paediatric visual impairment in Western Australia: Results and lessons from a registry analysis.

Clinical registries are an important research tool to enhance our understanding of vision loss in the Australian paediatric population. We aim to provide an update on the epidemiology of visual impairment among Western Australian children using registry data analysis, and to highlight the challenges of registry data collection. This is a retrospective study of visual impairment and blindness registrations of children aged 0-16 years in Western Australia from 1996 to 2015. Blindness was defined as visual acuity ≤6/60 in the better-seeing eye or binocular visual field ≤20° diameter, with all other certifications labelled as visual impairment. Certificates were assessed for primary causes of vision loss by age strata and sex. Registration rate trends were analysed across three discrete registration periods. Of 11 800 certificates issued between 1996 and 2015, 728 certificates (6.2%) were issued to 710 children. Five hundred and twenty-nine (74.5%) certificates were issued for visual impairment and 181 (25.5%) for blindness. The leading cause of certification was inherited retinal disease (73, 10.3%), followed by cortical visual impairment (57, 8.0%) and albinism (56, 7.9%). The annual registration rate of visual impairment increased from 0.5 to 9.8 per 100 000 person-years across the study period, whereas blindness rates fell from 2.7 to 1.3. Overall registration rates of paediatric visual impairment in Western Australia are increasing, but these trends should be interpreted with caution given the known limitations of registry data. Enhancements of the registration process could be achieved through digitisation, inclusion of patient outcome data, and incentives for greater practitioner engagement.

Digital health technology to support patient-centered shared decision making at point of care for juvenile idiopathic arthritis.

Despite availability of multiple FDA approved therapies, many children with juvenile idiopathic arthritis (JIA) suffer pain and disability due to uncontrolled disease. The term JIA includes a heterogeneous set of conditions unified by chronic inflammatory arthritis, collectively affecting 1:1,000 children. When reviewing treatment options with families the rheumatologist currently refers to the experience of the average patient in relatively small controlled clinical trials, to consensus-based treatment plans, or increasingly the choice is dictated by the formulary restrictions of insurance payers. The current paradigm for treatment selection does not incorporate real-world evidence of treatment effectiveness centered to the individual patients with whom decisions are to be made. Treatment decisions based on the evidence of the average patient are not optimized to reflect the unique clinical characteristics of an individual with JIA and their disease course, nor does it account for heterogeneous treatment effects. To guide treatment choices centered around each patient, we describe a novel concept of utilizing digital health technology to bring patient-centered information into shared decision-making discussions based on comparative effectiveness analysis of electronic health record or observational clinical registry data of patients with similar characteristics. The envisioned digital tool will organize and present data relevant to the individual patient and enable evidence-based individualized treatment decision making when used in a collaborative manner with the patient family and rheumatologist. Capabilities in digital health technology, data capturing, and analytical methodologies are ripe for this endeavor. This brings the concept of a learning health system directly to the point of care.

Prehospital factors associated with mortality among road traffic injury patients: analysis of Cameroon trauma registry data

BackgroundCameroon is amongst the worst affected countries by road traffic injuries with an estimated 1443 disability-adjusted life years per 100,000 population. There have been very limited reports on the crucial prehospital response to road traffic injuries in Cameroon. This study aimed to identify prehospital factors associated with RTI mortality in Cameroon.MethodsWe included patients enrolled between June 2022 and March 2023 in the Cameroon Trauma Registry. Information about prehospital factors and demographic data was obtained from patients or their proxies. We examined the association of prehospital care factors like care at the crash scene and type of transportation during crash with final patient outcome. We used Chi-squared test to investigate the association between selected independent variables and mortality. A multivariable logistic regression model was built to identify independent predictors of dying from an RTI.ResultsRTIs constituted 69.5% (n = 3203) of all injuries in the Cameroon Trauma Registry. Only 20.7% (n = 102) of 4 + wheel vehicle occupants had seatbelts on and just 2.7% (n = 53) of motorcycle riders were wearing helmets during the collision. Only 4.9% (n = 156) of patients received any form of scene care. In-hospital mortality was 4.3% (n = 139) and was associated with male sex (AOR = 1.7, 95%CI = 1.08–2.80), crashing on a motorcycle (AOR = 2.08, 95%CI = 1.1–3.67) and scene care (AOR = 0.25, 95%CI = 0.04–0.80).ConclusionsReceiving any type of care at the scene such as bleeding control or being placed in the recovery position by bystanders is associated with improved survival. Improving on existing informal prehospital care responses should be a priority in Cameroon.

Endoprosthetic treatment of femoral neck fractures in Germany : Cumulative analysis of EPRD registry data from 2013 to 2020

The German Arthroplasty Registry (EPRD) recorded nearly 52,000 femoral neck fractures treated with arthroplasty by 2020. This study aimed to identify survival rates and risk factors for hip prosthesis failure. The study included all patients with arthroplasty after hip fractures documented in the EPRD. Data were analyzed with focus on failure rate regarding implant, implantation technique, age, BMI, and comorbidities. For more complex analysis of dependencies, the machine learning algorithm (MLA) XGBoost (Extreme Gradient Boosting) was used. The study included 51,938 patients. The failure rate was 3.7% for HEs and 5.6% for THA. The failure rate increased in male patients (p < 0.0001), those with higher BMI, young patients with a high Elixhauser Comorbidity Score (ECS) and a cementless technique. The timepoint of surgery, i.e. ,working day vs. weekend or holiday had no influence on the outcome. The feature importance (FI) generated by MLA demonstrated factors with the highest impact on failure, i.e., survival time (1029), BMI (722), and age (481). For younger patients with comorbidities, acemented implantation technique should be considered. Failure rates of arthroplasties did not differ on workdays compared to weekends or holidays. MLA are suitable to analyze registry data for complex correlations of factors.

Assessing the Predictive Utility of the C-Reactive Protein-to-Lymphocyte Ratio for Mortality in Isolated Traumatic Brain Injury: A Single-Center Retrospective Analysis.

Introduction: Early identification of high-risk traumatic brain injury (TBI) patients is crucial for optimizing treatment strategies and improving outcomes. The C-reactive protein-to-lymphocyte ratio (CLR) reflects systemic immunology and inflammation function and serves as a new biomarker for patient stratification. This study aimed to assess the predictive value of the CLR for mortality in patients with isolated moderate to severe TBI. Methods: A retrospective analysis of trauma registry data from 2009 to 2022 was conducted, including 1641 adult patients with isolated moderate to severe TBI. Patient demographics, the CLR, injury characteristics, and outcomes were compared between deceased and surviving patients. Univariate and multivariate analyses were performed to identify mortality risk factors. The optimal CLR cut-off value for predicting mortality was determined using receiver operating characteristic (ROC) curve analysis. Results: The CLR was significantly higher in deceased patients compared to survivors (60.1 vs. 33.9, p < 0.001). The optimal CLR cut-off value for predicting mortality was 54.5, with a sensitivity of 0.328 and a specificity of 0.812. The area under the ROC curve was 0.566, indicating poor discriminative ability. In the multivariate analysis, the CLR was not a significant independent predictor of mortality (OR 1.03, p = 0.051). After propensity score matching to attenuate the difference in baseline characteristics, including sex, age, comorbidities, conscious level, and injury severity, the high-CLR group (CLR ≥ 54.5) did not have significantly higher mortality compared to the low-CLR group (CLR < 54.5). Conclusion: While the CLR was associated with mortality in TBI patients, it demonstrated poor discriminative ability as a standalone predictor. The association between a high CLR and worse outcomes may be primarily due to other baseline patient and injury characteristics, rather than the CLR itself.

One year analysis of Prospective Memory Clinics Registry in Qatar: A Critical Tool for Dementia Research and Policy Planning.

The Global Dementia Observatory (GDO) is a monitoring and accountability tool for the Global Action Plan on Public Response to Dementia 2017-25. Evidence from dementia registries may be utilized to better address WHO efforts in member countries, as well as to improve clinical practice and public health policy. The goal of this study was to analyze one-year data from a prospective memory clinic registry. This study was a baseline analysis of prospective memory clinics registry data of Qatar from January 1, 2023, through December 31, 2023. This study investigated the demographic, clinical, and lifestyle characteristics of 464 participants who were enrolled in memory clinics. Mild neurocognitive disorders were the most prevalent diagnoses in both sexes, affecting 61.5% of male patients and 63.7% of female patients. Dementia was slightly more common in men (19.8% vs. 18.9%), although delirium was more common in women (1.9% vs. 0%). In terms of risk factors, the analysis revealed that females were more likely to be obese (36.8% vs. 16.7% in males), while males had higher rates of diabetes (61.1% vs. 51.9% in females), hypertension (69.4% vs. 62.7% in females), and smoking (17.1% vs. 3.8% in females). The findings of this study highlight the differences in dementia risk factors between genders and races, highlighting the need for customized interventions. Furthermore, the registry is a great resource for policymakers and healthcare professionals, providing evidence-based suggestions to improve dementia care, increase the well-being of patients and caregivers, and maximize resource allocation.

Trends in incidence and mortality for gynaecological cancers in Southeastern China during 2011–2020: a retrospective analysis of registry data

ObjectivesThis study aimed to investigate the changes in the incidence and mortality trends of ovarian cancer (OC), cervical cancer (CC) and uterine cancer (UC) in the Fujian Province, southeastern China.DesignProvincial,...

Lung transplant referral considerations for individuals with cystic fibrosis.

The cystic fibrosis (CF) Foundation issued guidelines to promote timely lung transplant referral for people with cystic fibrosis (pwCF) in 2019. Since then more has been published to help refine this complex decision. The goal of this review is to summarize the recent literature informing disease severity in CF, barriers to referral for pwCF and guide timely and appropriate lung transplant referrals. Existing guidelines utilize the degree of airflow limitation as the primary criteria to refer for lung transplant, yet this variable has some prognostic uncertainty. Novel prognostic tools may provide more reliable metrics for predicting who with CF is at greatest risk of dying from their lung disease and could be used as an indicator for when to refer. In addition, updated analyses of national registry data have highlighted the significance of hemoptysis, low body mass index, and extra-pulmonary organ failure, as important prognostic markers. PwCF with these complications have historically been under-referred for lung transplant despite data suggesting lung transplant can be safe for some in these populations. Early referral should be considered in the presence of these complications. This review builds on existing guidelines by incorporating novel data to better determine when lung transplant referral is most appropriate. Improved prognostic tools are still needed to decrease the chances of pwCF dying without consideration of lung transplant. It is still unclear how novel therapies for CF may change the need and timing for lung transplant referral.

Health Care Provider Clustering Using Fusion Penalty in Quasi-Likelihood.

There has been growing research interest in developing methodology to evaluate the health care providers' performance with respect to a patient outcome. Random and fixed effects models are traditionally used for such a purpose. We propose a new method, using a fusion penalty to cluster health care providers based on quasi-likelihood. Without any priori knowledge of grouping information, our method provides a desirable data-driven approach for automatically clustering health care providers into different groups based on their performance. Further, the quasi-likelihood is more flexible and robust than the regular likelihood in that no distributional assumption is needed. An efficient alternating direction method of multipliers algorithm is developed to implement the proposed method. We show that the proposed method enjoys the oracle properties; namely, it performs as well as if the true group structure were known in advance. The consistency and asymptotic normality of the estimators are established. Simulation studies and analysis of the national kidney transplant registry data demonstrate the utility and validity of ourmethod.

No Clinically Significant Differences in Outcomes After Anterior Cruciate Ligament Reconstruction When Comparing Quadriceps, Bone–Patellar Tendon–Bone, and Hamstring Autografts of 9 mm or Greater

To determine whether there are patient-reported outcome differences in bone-patellar tendon-bone (BPTB), quadriceps tendon (QT), and hamstring (HS) grafts of comparable size. We performed a retrospective analysis of global registry data to include all patients who had an anterior cruciate ligament reconstruction with BPTB, QT, or HS autograft of at least 9 mm in diameter between 2010 and 2021 with complete 1- and 2-year outcome scores. We compared 1- and 2-year postoperative outcome scores (visual analog scale [VAS], Knee Injury and Osteoarthritis Outcome Score [KOOS] pain, Marx Activity Rating Scale [MARS], Veterans RAND 12-Item Health Survey [VR-12]) between BPTB, QT, and HS of the same size graft. In total, 2,318 subjects were included in the analysis, and all graft types showed improved patient-reported outcome measures at 1 and 2 years postoperatively when compared with baseline. The KOOS pain score for the BPTB group was significantly better than the HS (between-group difference= 2.71, P < .01) and QT (between-group difference= 2.51, P < .01) groups at 1 year, and the BPTB group was better than HS (between-group difference= 1.88, P < .01) at 2 years. However, the differences were small and not clinically meaningful. When we compared graft type, there were no differences in the percentage of patients who reached Minimal clinically important difference, or clinical scores VAS or MARS at 2-year follow-up. There is no clinically meaningful difference in KOOS-pain, VR-12, VAS, and MARS at 1 and 2 years postoperatively in patients having anterior cruciate ligament reconstruction with BPTB, HS, or QT if graft size is at least 9 mm in diameter. Level III, retrospective comparative study.

Differences in cancer rates among adults born between 1920 and 1990 in the USA: an analysis of population-based cancer registry data

Trends in cancer incidence in recent birth cohorts largely reflect changes in exposures during early life and foreshadow the future disease burden. Herein, we examined cancer incidence and mortality trends, by birth cohort, for 34 types of cancer in the USA. In this analysis, we obtained incidence data for 34 types of cancer and mortality data for 25 types of cancer for individuals aged 25-84 years for the period Jan 1, 2000, to Dec 31, 2019 from the North American Association of Central Cancer Registries and the US National Center for Health Statistics, respectively. We calculated birth cohort-specific incidence rate ratios (IRRs) and mortality rate ratios (MRRs), adjusted for age and period effects, by nominal birth cohort, separated by 5 year intervals, from 1920 to 1990. We extracted data for 23 654 000 patients diagnosed with 34 types of cancer and 7 348 137 deaths from 25 cancers for the period Jan 1, 2000, to Dec 31, 2019. We found that IRRs increased with each successive birth cohort born since approximately 1920 for eight of 34 cancers (pcohort<0·050). Notably, the incidence rate was approximately two-to-three times higher in the 1990 birth cohort than in the 1955 birth cohort for small intestine (IRR 3·56 [95% CI 2·96-4·27]), kidney and renal pelvis (2·92 [2·50-3·42]), and pancreatic (2·61 [2·22-3·07]) cancers in both male and female individuals; and for liver and intrahepatic bile duct cancer in female individuals (2·05 [1·23-3·44]). Additionally, the IRRs increased in younger cohorts, after a decline in older birth cohorts, for nine of the remaining cancers (pcohort<0·050): oestrogen-receptor-positive breast cancer, uterine corpus cancer, colorectal cancer, non-cardia gastric cancer, gallbladder and other biliary cancer, ovarian cancer, testicular cancer, anal cancer in male individuals, and Kaposi sarcoma in male individuals. Across cancer types, the incidence rate in the 1990 birth cohort ranged from 12% (IRR1990 vs 1975 1·12 [95% CI 1·03-1·21] for ovarian cancer) to 169% (IRR1990 vs 1930 2·69 [2·34-3·08] for uterine corpus cancer) higher than the rate in the birth cohort with the lowest incidence rate. The MRRs increased in successively younger birth cohorts alongside IRRs for liver and intrahepatic bile duct cancer in female individuals, uterine corpus, gallbladder and other biliary, testicular, and colorectal cancers, while MRRs declined or stabilised in younger birth cohorts for most cancers types. 17 of 34 cancers had an increasing incidence in younger birth cohorts, including nine that previously had declining incidence in older birth cohorts. These findings add to growing evidence of increased cancer risk in younger generations, highlighting the need to identify and tackle underlying risk factors. American Cancer Society.

Adverse Events in Patients Implanted With Biodegradable Polymer Drug-Eluting Stents, Durable Polymer Drug-Eluting Stents, and Bare-Metal Stents: A Retrospective Analysis of Registry Data

Adverse Events in Patients Implanted With Biodegradable Polymer Drug-Eluting Stents, Durable Polymer Drug-Eluting Stents, and Bare-Metal Stents: A Retrospective Analysis of Registry Data

Congenital heart defects and consanguinity: An analysis of the Sidra cardiac registry data in Qatar

Congenital heart defects and consanguinity: An analysis of the Sidra cardiac registry data in Qatar

Pitfalls in time-to-event analysis of registry data: a tutorial based on simulated and real cases.

Survival analysis (also referred to as time-to-event analysis) is the study of the time elapsed from a starting date to some event of interest. In practice, these analyses can be challenging and, if methodological errors are to be avoided, require the application of appropriate techniques. By using simulations and real-life data based on the French national registry of patients with primary immunodeficiencies (CEREDIH), we sought to highlight the basic elements that need to be handled correctly when performing the initial steps in a survival analysis. We focused on non-parametric methods to deal with right censoring, left truncation, competing risks, and recurrent events. Our simulations show that ignoring these aspects induces a bias in the results; we then explain how to analyze the data correctly in these situations using non-parametric methods. Rare disease registries are extremely valuable in medical research. We discuss the application of appropriate methods for the analysis of time-to-event from the CEREDIH registry. The objective of this tutorial article is to provide clinicians and healthcare professionals with better knowledge of the issues facing them when analyzing time-to-event data.

Trends in Medicare Costs of Hyperbaric Oxygen Therapy, 2013 through 2022

ABSTRACT Gelly H, Fife C, Walker D, Eckert K. Trends in Medicare Costs of Hyperbaric Oxygen Therapy, 2013 through 2022. Undersea Hyperb Med. 2024 Second Quarter; 51(2):137-144. Objective: To analyze Hyperbaric Oxygen Therapy Registry (HBOTR) data to estimate the Medicare costs of hyperbaric oxygen therapy (HBO2) based on standard treatment protocols and the annual mean number of treatments per patient reported by the registry. Methods: We performed a secondary analysis of deidentified data for all payers from 53 centers registered in the HBOTR from 2013 to 2022. We estimated the mean annual per-patient costs of HBO2 based on Medicare (outpatient facility + physician) reimbursement fees adjusted to 2022 inflation using the Medicare Economic Index. Costs were calculated for the annual average number of treatments patients received each year and for a standard 40-treatment series. We estimated the 2022 costs of standard treatment protocols for HBO2 indications treated in the outpatient setting. Results: Generally, all costs decreased from 2013 to 2022. The facility cost per patient per 40 HBO2 treatments decreased by 10.7% from $21,568.58 in 2013 to $19,488.00 in 2022. The physician cost per patient per 40 treatments substantially decreased by -37.8%, from $5,993.16 to $4,346.40. The total cost per patient per 40 treatments decreased by 15.6% from $27,561.74 to $23,834.40. In 2022, a single HBO2 session cost $595.86. For different indications, estimated costs ranged from $2,383.4-$8,342.04 for crush injuries to $17,875.80-$35,751.60 for diabetic foot ulcers and delayed radiation injuries. Conclusions: This real-world analysis of registry data demonstrates that the actual cost of HBO2 is not nearly as costly as the literature has insinuated, and the per-patient cost to Medicare is decreasing, largely due to decreased physician costs.

20 Years of triple-valve surgery in the UK: demographic and outcome trends.

To describe evolving demographic trends and early outcomes in patients undergoing triple-valve surgery in the UK between 2000 and 2019. We planned a retrospective analysis of national registry data including patients undergoing triple-valve surgery for all aetiologies of disease. We excluded patients in a critical preoperative state and those with missing admission dates. The study cohort was split into 5 consecutive 4-year cohorts (groups A, B, C, D and E). The primary outcome was in-hospital mortality, and secondary outcomes included prolonged admission, re-exploration for bleeding, postoperative stroke and postoperative dialysis. Binary logistic regression models were used to establish independent predictors of mortality, stroke, postoperative dialysis and re-exploration for bleeding in this high-risk cohort. We identified 1750 patients undergoing triple-valve surgery in the UK between 2000 and 2019. Triple valve surgery represents 3.1% of all patients in the dataset. Overall mean age of patients was 68.5 ± 12 years, having increased from 63 ±12 years in group A to 69 ± 12 years in group E (P < 0.001). Overall in-hospital mortality rate was 9%, dropping from 21% in group A to 7% in group E (P < 0.001). Overall rates of re-exploration for bleeding (11%, P = 0.308) and postoperative dialysis (11%, P = 0.066) remained high across the observed time period. Triple valve replacement, redo sternotomy and poor preoperative left ventricular ejection fraction emerged as strong independent predictors of mortality. Triple-valve surgery remains rare in the UK. Early postoperative outcomes for triple valve surgery have improved over time. Redo sternotomy is a significant predictor of mortality. Attempts should be made to repair the mitral and/or tricuspid valves where technically possible.

PT44 Prevalence of Comorbidities and Hospitalization in the 65 and over SLE (SYSTEMIC LUPUS ERYTHEMATOSUS) Patient Population: A Comparative Analysis of the FORWARD Lupus Registry and Medicare Data in the US (2017-2021)

PT44 Prevalence of Comorbidities and Hospitalization in the 65 and over SLE (SYSTEMIC LUPUS ERYTHEMATOSUS) Patient Population: A Comparative Analysis of the FORWARD Lupus Registry and Medicare Data in the US (2017-2021)