Abdelrahman Ahmed

Regional Variation in Mortality, Length of Stay, Cost, and Discharge Disposition Among Patients Admitted for Heart Failure in the United States

The objective of the study was to provide contemporary evidence on regional variation in hospitalization outcomes in patients with heart failure (HF) in the United States. Using the National Inpatient Sample, we compared hospitalization outcomes among primary HF admissions (2013 to 2014) among the 4 Census regions of the United States. Overall, an estimated 1.9 million HF hospitalizations occurred in the United States over the study period. Mortality rate was 3%, the mean length of stay was 5.3 days, the median cost of hospitalization was US

THE USE OF RIGHT VENTRICULAR IMPELLA IN A PATIENT WITH RIGHT VENTRICULAR FAILURE SECONDARY TO MASSIVE PULMONARY EMBOLISM: A NOVEL ALTERNATIVE TO SURGICAL THROMBECTOMY

7,248, and the rate of routine home discharge was 51%. There was a significant regional variation for all end points (pu2009<0.001); for example, compared with other regions of the country, the risk-adjusted rate of in-hospital mortality was highest in the Northeast (3.2%) and lowest in the Midwest (2.7%); and within each region, these mortalities were higher in the rural locations (range: 3.0% to 3.8%) than in the urban locations (range: 2.7% to 3.1%). In addition, the Northeast region had the longest length of stay (mean: 5.9 days) and the lowest risk-adjusted rate of routine home discharge (42%). However, the cost of hospitalization was highest in the West (median: US

Clinical impact of advanced chronic kidney disease on outcomes and in-hospital complications of Takotsubo Syndrome (broken-heart-syndrome): Propensity-matched national study

8,898) and lowest in the South (US

Outcomes and Effects of Hepatic Cirrhosis in Patients Who Underwent Transcatheter Aortic Valve Implantation

6,366). A similar pattern of variation was found in subgroup analysis except that the risk-adjusted rate of in-hospital mortality was highest in the West among patients <65 years (1.7% vs 1.2% [lowest] in the Midwest), male gender (3.2% vs 2.8% in the Midwest), and rural location (3.8% vs 3% in the Midwest). In conclusion, HF hospitalization outcomes tend to be worse in the Northeast compared with other regions of the country. In addition, the in-hospital mortality rate was higher in rural locations than in urban locations.

SEASONAL VARIATION IN IN-PATIENT MORTALITY, COST OF HOSPITALIZATION AND LENGTH OF STAY IN HEART FAILURE PATIENTS IN THE UNITED STATES

Right ventricular (RV) failure due to acute pulmonary embolism (PE) can be life-threatening. It can lead to cardiogenic shock with mortality rate up to 40%.nnA 44-year-old woman with history of PE, presented with right leg swelling, chest pain and shortness of breath. She stopped taking her Coumadin

REGIONAL VARIATION IN HOSPITALIZATION OUTCOMES AMONG PATIENTS ADMITTED FOR HEART FAILURE IN THE UNITED STATES

Multiple studies evaluated the outcomes and complications rate of Takotsubo Syndrome (TTS) in patients with and without advanced chronic kidney disease (CKD), revealed conflicting results. This study aims to assess the clinical outcomes and impact of advanced CKD on patients hospitalized with Takotsubo Syndrome. Patients who presented with Takotsubo cardiomyopathy between 2010 and 2014 were identified in the National Inpatient Sample (NIS) database using the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM), and subsequently were divided into two groups, with advanced CKD and without advanced CKD. NIS is the largest all-payer inpatient stays database in the United States. The primary outcome was the effect of advanced CKD on inpatient mortality in comparison to the non-advanced CKD group. Secondary outcomes were the impact of CKD on TTS in-hospital complications. We also evaluated the length of hospital stay and the cost of hospitalization. Propensity score-matched analysis was performed to address potential confounding. The advanced CKD group had no significant increase in the risk of In-hospital mortality (OR 0.99; 95% CI 0.75-1.31, Pu202f=u202f0.269). However, advanced CKD patients were more likely to develop acute kidney injury (AKI) requiring dialysis (OR: 5.12, 95% CI: 3.16-8.30, Pu202f=u202f<0.0001), and were more likely to stay longer at the hospital (OR 1.12; 95% CI 1.03 to 1.22, P 0.010). In conclusion, advanced chronic kidney disease does not increase immediate in-hospital mortality, neither most of the TTS in-hospital complications, apart from AKI and hospital length of stay, in comparison to the patients with non-advanced CKD.

Seasonal variation in hospitalization outcomes in patients admitted for heart failure in the United States

Comparative outcomes of transcatheter aortic valve implantation (TAVI) in patients with and without liver cirrhosis are scarce. This study aimed to assess the clinical outcomes and impact of liver cirrhosis on patients who underwent TAVI. Patient with liver cirrhosis who underwent TAVI 2011 to 2014 were identified in the National Inpatient Sample database using the International Classification of Diseases, ninth revision, Clinical Modification (ICD-9-CM). The primary outcome was the effect of liver cirrhosis on inpatient mortality. Secondary outcomes were the impact of liver cirrhosis on post-TAVI complications. We also evaluated the length of hospital stay and the cost of hospitalization. Propensity score-matched analysis was performed to address potential confounding. The cirrhotic patients who underwent TAVI had no significant increase in the risk of in-hospital mortality (odds ratio [OR] 1.12, 95% confidence interval [CI] 0.59 to 2.10, p = 0.734) or after procedural complications. Furthermore, cirrhotic patients were less likely to develop vascular complications requiring surgery (OR 0.47, 95% CI 0.23 to 0.98, p = 0.043), to develop after procedural deep vein thrombosis(OR <0.00, 95% CI <0.001 to <0.0001, p <0.0001), and to require pacemaker implantation. However, cirrhotic patients were more likely to undergo nonroutine hospital discharges (OR 1.50, 95% CI 1.15 to 1.96, p = 0.003). In conclusion, TAVI is a safe and reasonable therapeutic option for cirrhotic patients with severe aortic stenosis, requiring aortic valve replacement.

BILATERAL SEVERE VALVULAR REGURGITATION AFTER MEDIASTINAL RADIOTHERAPY IN A HODGKIN'S LYMPHOMA SURVIVOR: RADIATION DOES NOT READ TEXT BOOKS

Background: We sought to evaluate seasonal variation in hospitalization outcomes including in-patient mortality, cost of hospitalization and length of stay in heart failure patients in the United States.nnMethods: This study was conducted using the National Inpatient Sample (NIS) of the Agency for

Aspirin Resistance: Cardiovascular Risk Game Changer

Background: We sought to evaluate regional variation in heart failure (HF) hospitalization outcomes including in-patient mortality, cost of hospitalization, length of stay, and disposition of patients in the U.S.nnMethods: This study was conducted using the National Inpatient Sample (NIS) of the

Comparative analysis of the effect of bevacizumab maintenance regimens after first-line chemotherapy in patients with metastatic colorectal cancer (MCRC): A single institution experience.

There is lack of evidence of the impact of varying season on heart failure (HF) hospitalization outcomes in the U.S.