Trends In Hospitalizations Research Articles

Post-Pandemic Trends in the Hospitality Industry

Purpose: The general objective of this study was to explore post-pandemic trends in the hospitality trends. Methodology: The study adopted a desktop research methodology. Desk research refers to secondary data or that which can be collected without fieldwork. Desk research is basically involved in collecting data from existing resources hence it is often considered a low cost technique as compared to field research, as the main cost is involved in executive’s time, telephone charges and directories. Thus, the study relied on already published studies, reports and statistics. This secondary data was easily accessed through the online journals and library. Findings: The findings reveal that there exists a contextual and methodological gap relating to the post-pandemic trends in the hospitality trends. Preliminary empirical review revealed that the COVID-19 pandemic brought significant, lasting changes, with technology playing a crucial role in recovery through the adoption of contactless services. The shift towards domestic tourism and staycations provided a boost, supported by targeted local tourism campaigns. Sustainability emerged as a vital trend, with eco-friendly practices leading to higher occupancy rates and guest satisfaction. Flexibility in booking and cancellation policies restored traveler confidence, with adaptable and transparent communication being key to maintaining customer trust and loyalty. Unique Contribution to Theory, Practice and Policy: The Diffusion of Innovations Theory, Resource- Based View (RBV) and Expectancy Theory may be used to anchor future studies on post-pandemic trends in the hospitality trends. The study recommended several key areas for advancement. It emphasized the need for further research on the long-term impacts of technological innovations, suggesting that theories like the Diffusion of Innovations Theory be expanded to incorporate the effects of global crises. Practically, it advised sustained investment in digital infrastructure and training for staff to maximize the benefits of contactless technologies. Policy recommendations included government support for technological adoption, promotion of domestic tourism, and the prioritization of sustainability through green practices and supportive policies. Additionally, the study underscored the importance of maintaining flexible booking and cancellation policies to enhance traveler confidence and loyalty Keywords: Post-Pandemic Trends, Hospitality Industry, Technological Innovations, Contactless Technologies, Digital Infrastructure

Trends of Hospitalizations and In-Hospital Outcomes for Traumatic Cardiac Injury in United States.

Traumatic cardiac injury (TCI) poses a significant risk of morbidity and mortality, yet there is a lack of population-based outcomes data for these patients. The authors examined national yearly trends, demographics, and in-hospital outcomes of TCI using the National Inpatient Sample from 2007 to 2014. We focused on adult patients with a primary discharge diagnosis of TCI, categorizing them into blunt (BTCI) and penetrating (PTCI) cardiac injury. A total of 11,510 cases of TCI were identified, with 7,155 (62.2%) classified as BTCI and 4,355 (37.8%) as PTCI. BTCI was predominantly caused by motor vehicle collisions (66.7%), while PTCI was mostly caused by piercing injuries (67.4%). The overall mortality rate was 11.3%, significantly higher in PTCI compared to BTCI (20.3% vs. 5.9%, χ2(1, N = 11,185) = 94.9, p <0.001). Additionally, 21.5% required blood transfusion, 19.6% developed hemopericardium, and 15.9% suffered from respiratory failure. Procedures such as heart and pericardial repair were more common in PTCI patients. Length of hospitalization and cost of care were also significantly higher for PTCI patients, W(1, N = 11,015) = 88.9, p <0.001). Patients with PTCI experienced higher mortality rates than those with BTCI. Within the PTCI group, young men from minority racial groups and low-income households had poorer outcomes. This highlights the need for early and specialized attention from emergency and cardiothoracic providers for patients in these demographic groups.

Trends in Veteran hospitalizations and associated readmissions and emergency department visits during the MISSION Act era.

To examine changes in hospitalization trends and healthcare utilization among Veterans following Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act implementation. VA Corporate Data Warehouse and Centers for Medicare and Medicaid Services datasets. Retrospective cohort study to compare 7- and 30-day rates for unplanned readmission and emergency department visits following index hospital stays based on payor type (VHA facility stay, VA-funded stay in community facility [CC], or Medicare-funded community stay [CMS]). Segmented regression models were used to compare payors and estimate changes in outcome levels and slopes following MISSION Act implementation. Veterans with active VA primary care utilization and ≥1 acute hospitalization between January 1, 2016 and December 31, 2021. Monthly index stays increased for all payors until MISSION Act implementation, when VHA and CMS admissions declined while CC admissions accelerated and overtook VHA admissions. In December 2021, CC admissions accounted for 54% of index admissions, up from 25% in January 2016. From adjusted models, just prior to implementation (May 2019), Veterans with CC admissions had 47% greater risk of 7-day readmission (risk ratio [RR]: 1.47, 95% confidence interval [CI]: 1.43, 1.51) and 20% greater risk of 30-day readmission (RR: 1.20, 95% CI: 1.19, 1.22) compared with those with VHA admissions; both effects persisted post-implementation. Pre-implementation CC admissions were also associated with higher 7- and 30-day ED visits, but both risks were substantially lower by study termination (RR: 0.90, 95% CI: 0.88, 0.91) and (RR: 0.89, 95% CI: 0.87, 0.90), respectively. MISSION Act implementation was associated with substantial shifts in treatment site and federal payor for Veteran hospitalizations. Post-implementation readmission risk was estimated to be higher for those with CC and CMS index admissions, while post-implementation risk of ED utilization following CC admissions was estimated to be lower compared with VHA index admissions. Reasons for this divergence require further investigation.

Impact of SARS-CoV-2 Pandemic on Emergency Hospitalizations for Acute Respiratory Infections: The Experience of a Paediatric Tertiary Care Hospital in Italy.

Acute respiratory infections (ARIs) are a major healthcare issue in children. The SARS-CoV-2 pandemic changed the epidemiology of ARIs; the aims of this study are to characterize the epidemiological trend of ARI emergency hospitalizations and virology results and to estimate the association of ARI emergency hospitalizations with respiratory viruses from January 2018 to June 2023. This study was carried out in an Italian tertiary care children's hospital (Bambino Gesù Children's Hospital). The demographic and clinical information of children who accessed the Emergency Department (ED) with ARI and were hospitalized were retrospectively extracted from the electronic health records. Multivariate linear regression model was used to compare the number of ARI hospital admissions with the reported temporal trends in viruses diagnosed from respiratory samples throughout the same time period. During the study period, there were 92,140 ED visits and 10,541 hospitalizations due to ARIs, reflecting an admission rate of 11.4%. The highest proportion of hospitalizations occurred in infants ≤ 1 year of age (n = 4840, 45.9% of total admissions), with a hospitalization rate of 22.6%. Emergency hospitalizations aligned closely with the predictions made by the multivariate regression model; peaks in hospitalizations reflected Respiratory Syncytial Virus (RSV) circulation. ARI hospital urgent admissions are a relevant component of ARI disease burden in children. RSV prevention and control are crucial to limit the risk of urgent hospitalizations due to ARIs.

Understanding trends of US breast cancer hospitalization, mortality and costs using the National Inpatient Sample database.

11162 Background: Studies have shown a rising breast cancer incidence in the US. However, its impact on healthcare utilization is unclear. Our study delves into the previously unexplored territory of hospitalization and cost trends among breast cancer patients, aiming to shed light on resource allocation and potential areas for improvement. Methods: To investigate trends in breast cancer admissions and costs, we queried the National Inpatient Sample database. Patients admitted between January 2011 and December 2019 with following criteria were included in the analysis: female gender, age ≥ 18, and ICD diagnosis code corresponding to unspecified malignant neoplasm of the breast as their primary reason for admission. Our primary outcome was defined as the temporal trends in the number of admissions, discharge rates, length of stay, and cost of hospitalization and mortality rates. Analyses were performed using Stata version 15.1 College station TX: StataCorp LP 2017. Appropriate discharge weights were applied to the dataset during the analyses to account for critical elements of sampling design. A p-value of &lt;0.05 was considered statistically significant. Results: Between 2011 and 2019, hospital admissions for breast cancer as the primary diagnosis declined significantly, from 32,126 to 12,742 (P &lt; 0.001). However, while average length of stay increased slightly from 4.3 to 4.9 days (P &lt; 0.01), hospital charges for breast cancer rose dramatically. Adjusted for inflation, mean charges per patient rose 38.8%, from $50,663.86 in 2011 to $70,334.11 in 2019 (P &lt; 0.001). Despite this surge, the total aggregate cost ("national burden") of hospitalizations with breast cancer as main discharge diagnosis decreased, falling from $1.63 billion in 2011 to $896 million in 2019 (inflation adjusted) (P &lt; 0.001). Discharges for breast cancer peaked in women between 45 and 64, followed by the 65-84 demographic. Compared to the overall decrease in hospitalization rates, the declines in the above age groups were notably steeper with declines of 62% for 45-64 and 48% for 65-84 (p&lt;0.001). Although absolute number of breast cancer deaths decreased from 2011 to 2019, the mortality rate paradoxically increased from 4.3% to 5.8% over the same period (P &lt; 0.001). This seemingly contradictory trend warrants further investigation to better understand contributing factors. Conclusions: While breast cancer diagnoses are on the rise in women, our study reveals a fascinating paradox: significant declines in hospitalization, associated costs, and overall mortality. This encouraging trend likely stems from widespread surveillance mammography with increases in early stage, curable disease diagnosis, and the flourishing landscape of outpatient therapies, including targeted treatments, with more tolerable toxicity profiles allowing for majority of breast cancer care to be completed in the outpatient setting.

Trend and burden of cancer related hospitalizations in the US: Insights from a National Inpatient Sample Database analysis.

1543 Background: Cancer-related hospitalizations constitute one of the primary drivers of cancer-related healthcare expenses. Understanding the burden and characteristics of these hospitalizations is essential to appropriately direct resources, improve outcomes, and avoid unnecessary hospitalizations. Our study sought to evaluate the national trends, reasons, disposition status, length of stay, and associated costs for cancer-related hospitalizations. Methods: We conducted a retrospective analysis of cancer hospitalizations using the 2008-2019 National Inpatient Sample. Cancer-related hospitalizations were identified using validated Clinical Classification Software (CCS) codes 11 to 45. Trends in hospitalization volume, mortality, length of stay, disposition status, and costs were analyzed overall and by cancer type, adjusted according to the US Consumer Price Index. Results: There were 371 million weighted hospitalizations from 2008 to 2019, of which 15.1% (56 million) were cancer related. The most reported cancer types were breast cancer (11.9%), secondary malignancies (11.2%), and prostate cancer (10.3%). The most common reasons for cancer-related hospitalizations were septicemia (4.8%), pneumonia (4.7%), and complications of surgical procedures or medical care (3.1%). Trend analysis showed that the total number of cancer-related hospitalizationsincreased from 12,963 to 16,500 per 100,000 hospitalizations during the study period (relative increase, 27.3%). Mortality rates decreased from 5.1% to 4.0% (relative decrease, 21.6%), while the length of stay decreased from 3.5 to 3.2 days (relative decrease, 8.6%) during the study period. Disposition to home or short-term facilities decreased (relative decrease, 3.1%), while to long-term facilities increased (relative increase, 20.6%) during the same period. Total hospitalization cost increased from $55.5 billion in 2008 to $76.4 billion in 2019 (a relative increase of 37.7%). Conclusions: Our analysis shows that while cancer-related hospitalizations and associated costs increased substantially, mortality rates, and length of stay decreased. These trends reflect rising cancer burden but improvements in hospital cancer care quality and efficiency. Ongoing efforts to optimize cancer treatment, minimize unnecessary hospitalizations, reduce length of stay, and facilitate safe discharges are needed to improve patient outcomes and control costs further. Continued surveillance and health policies should address the rising demand for high-value cancer care.[Table: see text]

A two-decade trend analysis of in-hospital outcomes and racial/ethnic disparities among hospitalized patients with lung cancer in the United States.

11035 Background: Previous research has focused largely on the disease and healthcare cost burden of lung cancer (LC),however, long-term trends of hospitalizations among LC patients (pts) in the US are limited. We aimed to describe longitudinal trends in in-hospital outcomes among hospitalized LC pts, overall and by race/ethnicity. Methods: We analyzed data from the National Inpatient Sample database, spanning 1998 to 2020. The study cohort included pts aged ≥18 years with a principal LC diagnosis. We assessed four in-hospital outcomes: 1) hospitalization, 2) mortality, 3) length of stay (LOS), and 4) total hospitalization charges (THCs). THCs were adjusted for inflation using the Medicare Hospital Care Consumer Price Index.To quantify trends, we performed weighted analyses (weighted means or proportions) and calculated P-trend using Cochran-Armitage or Jonckheere-Terpstra tests. Results: Of 791,100 pts (mean age 68.2 years), 80.4% were White, followed by 11.9% Black, 4.7% Hispanic, and 3.0% Asian or Pacific Islander (API). Among US hospitalized pts in 1998, 0.54% had a principal LC diagnosis, with hospitalization rates having decreased to 0.37% in 2020 ( P-trend&lt;.001). By race/ethnicity, the LC hospitalization rate for White pts declined from 0.53% in 1998 to 0.39% in 2020; for Black pts, it declined from 0.35% to 0.26%; and for Hispanic pts, it declined from 0.18% to 0.12% (all P-trend&lt;.001). In contrast, the hospitalization rate for API pts increased from 0.30% in 1998 to 0.38% in 2020 ( P-trend&lt;.001). The overall LC-specific in-hospital mortality rate declined drastically from 15.9% in 1998 to 6.2% in 2020 ( P-trend&lt;.001); a similar pattern was observed across racial/ethnic groups. The LOS reduced from an average of 7.9 days in 1998 to 5.9 days in 2020 ( P-trend&lt;.001). By race/ethnicity, the LOS for White pts decreased from 7.8 days in 1998 to 5.2 days in 2020; for Black pts, it decreased from 9.0 to 7.0 days; for Hispanic pts, it decreased from 8.8 to 6.7 days; and it declined from 8.7 to 5.9 days in API pts (all P-trend&lt;.001). THCs rose significantly from $39,706 in 1998 to $92,734 in 2020 ( P-trend&lt;.001). In White pts, THCs rose from $39782 to $89,681; from $41,235 to $91,792 in Black pts; from $49,444 to $119,386 in Hispanic pts; and from $52,779 to $112,365 in API pts (all P-trend&lt;.001). Moreover, the odds of female pts hospitalized with LC was higher (AOR=1.47, 95% CI=1.40-1.54, P&lt;.001) in 2020 compared to 1998. Conclusions: In this racially diverse hospitalized LC cohort, LOS, rates of hospitalizations, and mortality rates have declined, while THCs have risen significantly, over the last 20 years. API and female pts bore a heavier burden of hospitalizations. Our findings suggest the need for targeted healthcare interventions or policies to reduce THCs and hospitalization disparities in LC pts.

Evaluating targeted COVID-19 vaccination strategies with agent-based modeling.

We evaluate approaches to vaccine distribution using an agent-based model of human activity and COVID-19 transmission calibrated to detailed trends in cases, hospitalizations, deaths, seroprevalence, and vaccine breakthrough infections in Florida, USA. We compare the incremental effectiveness for four different distribution strategies at four different levels of vaccine supply, starting in late 2020 through early 2022. Our analysis indicates that the best strategy to reduce severe outcomes would be to actively target high disease-risk individuals. This was true in every scenario, although the advantage was greatest for the intermediate vaccine availability assumptions and relatively modest compared to a simple mass vaccination approach under high vaccine availability. Ring vaccination, while generally the most effective strategy for reducing infections, ultimately proved least effective at preventing deaths. We also consider using age group as a practical surrogate measure for actual disease-risk targeting; this approach also outperforms both simple mass distribution and ring vaccination. We find that quantitative effectiveness of a strategy depends on whether effectiveness is assessed after the alpha, delta, or omicron wave. However, these differences in absolute benefit for the strategies do not change the ranking of their performance at preventing severe outcomes across vaccine availability assumptions.

Racial Disparities in Alcoholic Hepatitis Hospitalizations in the United States: Trends, Outcomes, and Future Projections.

Alcoholic hepatitis (AH) is a serious complication of alcohol consumption with high morbidity and mortality, particularly in the United States where alcohol-related liver diseases rank as one of the leading causes of preventable death. Our study aims to analyze the morbidity and mortality of AH across racial groups and project hospitalization trends up to 2028, thereby informing public health initiatives. We conducted a cross-sectional study utilizing data from the Nationwide Inpatient Sample (NIS) spanning 2012 to 2021. The study population comprised hospitalizations identified using specific ICD-9-CM and ICD-10-CM codes for AH. We assessed hospitalizations, in-hospital mortality rates, length of stay (LOS), and morbidities related to alcoholic hepatitis adjusting for sociodemographic factors and hospital characteristics. Statistical analyses were performed using Stata and R software, employing logistic and linear regression analyses, and SARIMA models for forecasting. Our results indicated a predominantly White cohort (68%), with a notable increase in AH hospitalizations among Hispanics (129.1% from 2012 to 2021). Racial disparities were observed in inpatient mortality, liver transplant accessibility, and the occurrence of in-hospital complications. The study forecasts a continued rise in hospitalizations across all racial groups, with Hispanics experiencing the sharpest increase. Our study reveals a disproportionate rise in the AH burden among Hispanics with projections indicating a persistent upward trend through 2028. These findings highlight the need for targeted public health strategies and improved healthcare access to mitigate the increasing AH burden and address disparities in care and outcomes.

Trends in hospitalization of patients undergoing endovascular treatment of thoracoabdominal aortic aneurysms based on cerebrospinal fluid drainage strategy

ObjectiveThe aim of this study was to identify trends in hospital length of stay (HLOS) and intensive care unit length of stay (ICULOS), and the relationship with cerebrospinal fluid drainage (CSFD) protocols in patients undergoing fenestrated-branched endovascular aortic repair (FB-EVAR) of thoracoabdominal aortic aneurysms (TAAAs). MethodsA retrospective review of patients who underwent elective FB-EVAR for extent I to IV TAAAs between 2008 and 2023 at a single aortic center of excellence was conducted. Patient demographics, cardiovascular comorbidities, surgical risk, technical details, CSFD strategy (prophylactic or therapeutic), procedural success, and perioperative outcomes were collected. Patients were divided into two groups based on CSFD protocol. Group 1 included patients treated before 2020 when prophylactic CSFD was performed widely, and Group 2 consisted of patients treated since 2020 with therapeutic CSFD. Primary end points were HLOS, ICULOS, major adverse events, and perioperative mortality. ResultsFB-EVAR was performed in 702 patients; 412 underwent elective TAAA repair and were included in the analysis. Mean age was 73 ± 8 years and 68% were male. Patient-specific manufactured devices were used in 252 patients (61%), physician-modified endografts in 110 (27%), and 50 patients (12%) were treated with off-the-shelf devices. Demographics, aneurysm extent, major adverse events (including spinal cord ischemia [SCI]), and mortality were similar in both groups. A significant reduction in mean HLOS between the groups (9 ± 9 vs 6 ± 5 days; P = .02) coincided with decreased use of prophylactic CSFD (70% vs 1.2%; P < .001), with similar rates of SCI (7.6% vs 4.9%; P = .627) and ICULOS (3 ± 3 vs 2.5 ± 3; P = .19). Patients in the therapeutic drainage cohort (group 2) had a higher incidence of congestive heart failure (24% vs 11%; P = .003), hypercholesterolemia (91% vs 80%; P = .015), chronic obstructive pulmonary disease (55% vs 37%; P = .004), and peripheral artery disease (39% vs 19%; P < .001) compared with group 1, suggesting treatment of a more complex patient cohort. On adjusted multivariable analysis accounting for American Society of Anesthesiologists score, comorbidities, and device type, the difference in HLOS remained statistically significant (P = .01). ConclusionsHLOS decreased over time in patients undergoing FB-EVAR for TAAA after transition from a prophylactic to a therapeutic CSFD protocol. This transition was the only modifiable, independent risk factor for a shorter HLOS, without an increase in SCI, albeit with similar ICULOS.

Mortality and hospitalization trends for aortic aneurysms and dissections in Mexico.

In Mexico, there is a paucity of evidence on mortality and hospitalization patterns associated with aortic aneurysms and dissections. To analyze national databases and describe the epidemiological characteristics of different aortic pathologies. Retrospective, cross-sectional, observational study, in which mortality and hospitalization attributed to aortic aneurysms and dissections were analyzed. Statistical analysis was performed on Stata 16. A total of 6,049 deaths were documented in the general population, which included 2,367 hospitalizations and 476 (20.1%) in-hospital deaths. In addition, a statistically significant age difference was found between mean age at death in the general population (69.5 years) and the in-hospital death group (64.1 years, p < 0.001). As for hospitalizations secondary to ruptured abdominal aortic aneurysms, 149 cases were identified, with a mean age of 65.6 years, out of whom 53 (35.5%) were under 65 years of age, with a mean age of 47.8 years. Epidemiological reports of aortic pathology in Mexico are scarce; therefore, implementation of screening and detection programs for aortic pathologies is necessary in order to address the disparities identified in this analysis.

Analysis of inpatient data on dengue fever, malaria and leishmaniasis in Ecuador: A cross-sectional national study, 2015–2022

BackgroundDespite concerted efforts in South America, these diseases continue to pose a significant burden of morbidity and mortality in endemic regions. This study aimed to analyse hospital data and investigate the hospitalisation rates of dengue fever, leishmaniasis, and malaria in Ecuador between 2015 and 2022. MethodsOpen-access databases from the National Institute of Statistics and Censuses of Ecuador between 2015 and 2022 were analysed. Data were filtered using specific terms for each disease (ICD-10), and descriptive statistics of geographical distributions were calculated using Microsoft Excel, Stata 14.2, and Rstudio. ResultsDengue had the highest burden, with 31,616 reported cases, followed by malaria (1,316) and leishmaniasis (283). From 2015 to 2022, the highest hospitalisation rate per 105 inhabitants for dengue was observed in Sucumbios province (697.2), for malaria in Pastaza province (108.4), and for leishmaniasis in Morona Santiago province (18.8). The data’s trend analysis revealed a slight increase in dengue and mild downward trends in hospitalisation for malaria and leishmaniasis. ConclusionsThe results suggest that vector-borne disease control has failed in Ecuador. Unfortunately, there was no significant trend towards a decrease in dengue, malaria, and leishmaniasis in Ecuador during the years studied. This study highlights the need to optimise sustainable vector control programs and emphasises continuous monitoring of disease incidence and control measures.

Trends in falls among older adults before and during the COVID-19 pandemic in Ontario, Canada: A retrospective observational study

BackgroundThe public health measures associated with the COVID-19 pandemic may have indirectly impacted other health outcomes, such as falls among older adults. The purpose of this study was to examine trends in fall-related hospitalizations and emergency department visits among older adults before and during the COVID-19 pandemic in Ontario, Canada.MethodsWe obtained fall-related hospitalizations (N = 301,945) and emergency department visit (N = 1,150,829) data from the Canadian Institute for Health Information databases from 2015 to 2022 for adults ages 65 and older in Ontario. Fall-related injuries were obtained using International Classification of Diseases, 10th edition, Canada codes. An interrupted time series analysis was used to model the change in weekly fall-related hospitalizations and emergency department visits before (January 6, 2015-March 16, 2020) and during (March 17, 2020-December 26, 2022) the pandemic.ResultsAfter adjusting for seasonality and population changes, an 8% decrease in fall-related hospitalizations [Relative Rate (RR) = 0.92, 95% Confidence Interval (CI): 0.85, 1.00] and a 23% decrease in fall-related emergency department visits (RR = 0.77, 95%CI: 0.59, 1.00) were observed immediately following the onset of the pandemic, followed by increasing trends during the pandemic for both outcomes.ConclusionsFollowing an abrupt decrease in hospitalizations and emergency department visits immediately following the onset of the pandemic, fall-related hospitalizations and emergency department visits have been increasing steadily and are approaching pre-pandemic levels. Further research exploring the factors contributing to these trends may inform future policies for public health emergencies that balance limiting the spread of disease among this population while supporting the physical, psychological, and social needs of this vulnerable group.

An Interrupted Time-Series Analysis of the Impact of COVID-19 on Hospitalizations for Vascular Events in 3 Canadian Provinces

BackgroundCOVID-19 infection is associated with a pro-coagulable state, thrombosis, and cardiovascular events. However, its impact on population-based rates of vascular events is less well understood. We studied temporal trends in hospitalizations for stroke and myocardial infarction in 3 Canadian provinces (Alberta, Ontario, and Nova Scotia) between 2014 and 2022. MethodsLinked administrative data from each province were used to identify admissions for ischemic stroke, intracerebral hemorrhage, cerebral venous thrombosis, and myocardial infarction. Event rates per 100,000/quarter, standardized to the 2016 Canadian population, were calculated. We assessed changes from quarterly rates pre-pandemic (2014-2020), compared to rates in the pandemic period (2020-2022), using interrupted time-series analysis with a jump discontinuity at pandemic onset. Age group– and sex-stratified analyses also were performed. ResultsWe identified 162,497 strokes and 243,182 myocardial infarctions. At pandemic onset, no significant step change in strokesper 100,000/quarter was observed in any of the 3 provinces. During the pandemic, stroke rates were stable in Alberta and Ontario, but they increased in Nova Scotia (0.44 per 100,000/quarter, P = 0.004). At pandemic onset, a significant step decrease occurred in myocardial infarctions per 100,000/quarter in Alberta (4.72, P < 0.001) and Ontario (4.84, P < 0.001), but not in Nova Scotia. During the pandemic, myocardial infarctions per 100,000/quarter decreased in Alberta (–0.34, P = 0.01), but they remained stable in Ontario and Nova Scotia. No consistent patterns by age group or sex were noted. ConclusionsHospitalization rates for stroke or myocardial infarction across 3 Canadian provinces did not increase substantially during the first 2 years of the pandemic. Continued surveillance is warranted as the virus becomes endemic.

Assessing Trends in Hospitalizations for Breast Cancer among Women in Korea: A Utilization of the Korea National Hospital Discharge In-depth Injury Survey (2006–2020)

ObjectiveBreast cancer poses a significant health threat globally and particularly in Korea, where mortality rates have risen notably. In this study, we analyzed the characteristics of breast cancer patients discharged in Korea over the past 15 years and explored the association between comorbidities and treatment outcomes to propose effective strategies for managing cancer patients. Understanding these dynamics is vital for informing tailored management strategies and optimizing healthcare system sustainability.MethodsThis study utilized cross-sectional data from the Korea National Hospital Discharge In-depth Injury Survey from 2006 to 2020. Each year, among patients discharged from hospital with 100 beds or more, those identified with breast cancer patients were based on their primary diagnosis code (C50) according to the ICD-10, as recorded in their medical records.ResultsBetween 2006 and 2020, an estimated 499,281 breast cancer patients were discharged, with an average annual percent change (AAPC) of 5.2% (95% CI 4.2–6.2, p <.05). A notable increase in AAPC was particularly evident among those aged 60 years and old. Across all age groups, there was a consistent increasing trend in the risk of mortality as the CCI score increased (p <.05). The risk of comorbidity was more pronounced in younger age groups compared to older age groups.ConclusionsThe increasing life expectancy is expected to lead to a continued rise in the number of elderly breast cancer patients. Countermeasures are needed to address this trend through appropriate diagnosis and treatment planning. Particularly, considering comorbidities in breast cancer treatment plans is necessary to promote positive treatment outcomes, especially in younger breast cancer patients.

The Burden of Herpes Zoster on Hospital Admissions: A Retrospective Analysis in the Years of 2015-2021 from the Abruzzo Region, Italy.

(1) Background: Herpes zoster (HZ) is a disease caused by the reactivation of the Varicella Zoster Virus (VZV). Clinical reactivation, herpes zoster, takes place in 10-20% of subjects who contracted the primary infection, with a higher risk of developing zoster increasing proportionally with age, especially after 50 years of age. HZ is a common clinical problem, particularly among patients aged over 50 years and immunocompromised patients. Immunocompromised patients and adults could present an atypical and more severe course. In addition, they are at greater risk of complications. For this reason, it is important to understand the real burden of the disease and to identify the subjects who are at higher risk of HZ and its complications, also to direct preventive strategies at the right targets. The aim of the present study is to analyze HZ-related hospitalization trends in Abruzzo in the period of 2015-2021. (2) Methods: Data related to hospital admissions were extracted from the hospital discharge records (HDRs) of the whole region, considering all admissions during the years of 2015-2021. The trends in hospital admissions and length of stay were evaluated and analyzed. (3) Results: A total of 768 hospital discharges with a diagnosis of herpes zoster were registered in Abruzzo during the 7-year study period. During the study period, an increasing trend was observed from the year 2015 to the year 2017, ranging from 8.19 cases/100,000 to 11.5 cases/100,000 (APC (Annual percentage change) +20.8%; 95%CI -2.3; 47.6). After the year 2017, a significantly decreasing trend was observed, reaching 5.46 cases/100,000 in the year 2021 (APC -18.4%; 95%CI -31.5; -12.0). Across the entire study period, an average annual percentage change (AAPC) of -7.0% (95%CI -13.0; -1.3) was observed. (4) Conclusions: Despite the trend of a reduction in hospitalizations, this study highlights that HZ continues to have a great impact on public health. So, it is important to update recommendations for the use of the already available HZ vaccine and to implement new strategies to increase awareness of the prevention of the disease.

Sepsis during short bowel syndrome hospitalizations: Identifying trends, disparities, and clinical outcomes in the United States.

Short bowel syndrome (SBS) hospitalizations are often complicated with sepsis. There is a significant paucity of data on adult SBS hospitalizations in the United States and across the globe. To assess trends and outcomes of SBS hospitalizations complicated by sepsis in the United States. The National Inpatient Sample was utilized to identify all adult SBS hospitalizations between 2005-2014. The study cohort was further divided based on the presence or absence of sepsis. Trends were identified, and hospitalization characteristics and clinical outcomes were compared. Predictors of mortality for SBS hospitalizations complicated with sepsis were assessed. Of 247097 SBS hospitalizations, 21.7% were complicated by sepsis. Septic SBS hospitalizations had a rising trend of hospitalizations from 20.8% in 2005 to 23.5% in 2014 (P trend < 0.0001). Compared to non-septic SBS hospitalizations, septic SBS hospitalizations had a higher proportion of males (32.8% vs 29.3%, P < 0.0001), patients in the 35-49 (45.9% vs 42.5%, P < 0.0001) and 50-64 (32.1% vs 31.1%, P < 0.0001) age groups, and ethnic minorities, i.e., Blacks (12.4% vs 11.3%, P < 0.0001) and Hispanics (6.7% vs 5.5%, P < 0.0001). Furthermore, septic SBS hospitalizations had a higher proportion of patients with intestinal transplantation (0.33% vs 0.22%, P < 0.0001), inpatient mortality (8.5% vs 1.4%, P < 0.0001), and mean length of stay (16.1 d vs 7.7 d, P < 0.0001) compared to the non-sepsis cohort. A younger age, female gender, White race, and presence of comorbidities such as anemia and depression were identified to be independent predictors of inpatient mortality for septic SBS hospitalizations. Septic SBS hospitalizations had a rising trend between 2005-2014 and were associated with higher inpatient mortality compared to non-septic SBS hospitalizations.

Trends and disparities in colorectal cancer hospitalizations and outcomes: a 10-year joinpoint trend study

Background Colorectal cancer (CRC) poses a significant burden on healthcare systems globally. Sociodemographic factors intricately influence CRC epidemiology, yet their impact on inpatient care remains underexplored. This study aimed to assess trends in CRC hospitalization and the effect of sociodemographic factors on outcomes of CRC patients. Methods A retrospective longitudinal analysis was conducted using data from the Healthcare Cost and Utilization Project National Inpatient Sample. Trends in CRC admissions were assessed, stratified by sociodemographic variables. Disparities in hospital-associated outcomes were examined. Statistical methods included multivariable regression and joinpoint regression analysis. Results The prevalence of CRC hospitalizations uptrended from 760 per 100,000 hospitalizations in 2010 to 841 per 100,000 hospitalizations in 2019 (P trend < 0.001). The mean age decreased from 67 to 66 years (P < 0.001). Male gender and White race were predominant across the study period. Inpatient mortality decreased from 4.5% in 2010 to 4.16% in 2019 (P trend = 0.033). On sex subgroup analysis, men had a significantly higher mortality rate (P = 0.034). Racially, Blacks had the highest mortality rate (P = 0.550) and only Whites showed a significant decline in mortality over the study period (P = 0.003). Hospitalization length decreased while total hospital charges increased. Conclusion Our study highlights sociodemographic disparities in CRC outcomes, emphasizing the need for targeted interventions to address inequity in screening, diagnosis, and treatment. Continued research is needed to inform effective healthcare practices in mitigating these disparities and improving survival outcomes.

Effects of COVID-19-targeted non-pharmaceutical interventions on pediatric hospital admissions in North Italian hospitals, 2017 to 2022: a quasi-experimental study interrupted time-series analysis.

The use of Non-Pharmaceutical Interventions (NPIs), such as lockdowns, social distancing and school closures, against the COVID-19 epidemic is debated, particularly for the possible negative effects on vulnerable populations, including children and adolescents. This study therefore aimed to quantify the impact of NPIs on the trend of pediatric hospitalizations during 2 years of pandemic compared to the previous 3 years, also considering two pandemic phases according to the type of adopted NPIs. This is a multicenter, quasi-experimental before-after study conducted in 12 hospitals of the Emilia-Romagna Region, Northern Italy, with NPI implementation as the intervention event. The 3 years preceding the beginning of NPI implementation (in March 2020) constituted the pre-pandemic phase. The subsequent 2 years were further subdivided into a school closure phase (up to September 2020) and a subsequent mitigation measures phase with less stringent restrictions. School closure was chosen as delimitation as it particularly concerns young people. Interrupted Time Series (ITS) regression analysis was applied to calculate Hospitalization Rate Ratios (HRR) on the diagnostic categories exhibiting the greatest variation. ITS allows the estimation of changes attributable to an intervention, both in terms of immediate (level change) and sustained (slope change) effects, while accounting for pre-intervention secular trends. Overall, in the 60 months of the study there were 84,368 cases. Compared to the pre-pandemic years, statistically significant 35 and 19% decreases in hospitalizations were observed during school closure and in the following mitigation measures phase, respectively. The greatest reduction was recorded for "Respiratory Diseases," whereas the "Mental Disorders" category exhibited a significant increase during mitigation measures. ITS analysis confirms a high reduction of level change during school closure for Respiratory Diseases (HRR 0.19, 95%CI 0.08-0.47) and a similar but smaller significant reduction when mitigation measures were enacted. Level change for Mental Disorders significantly decreased during school closure (HRR 0.50, 95%CI 0.30-0.82) but increased during mitigation measures by 28% (HRR 1.28, 95%CI 0.98-1.69). Our findings provide information on the impact of COVID-19 NPIs which may inform public health policies in future health crises, plan effective control and preventative interventions and target resources where needed.

739 Epidemiology of Accidental Burn Injuries: National Trends in Hospitalizations and Emergency Department Visits (2017-2022)

739 Epidemiology of Accidental Burn Injuries: National Trends in Hospitalizations and Emergency Department Visits (2017-2022)