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Trends and Outcomes of Hospitalizations Due to Hemolytic Uremic Syndrome: A National Perspective
Background: Hemolytic uremic syndrome (HUS) is a rare but challenging disease with varying degrees of mortality and prognosis. We aim to evaluate the trends and outcomes of hospitalizations due to HUS by utilizing a large population-based dataset. Methods: We derived a study cohort from the Nationwi...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9825057/ https://www.ncbi.nlm.nih.gov/pubmed/36628001 http://dx.doi.org/10.7759/cureus.32315 |
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author | Lingas, Elvina Mulayamkuzhiyil Saju, Jiya Abdulqader, Mohammed Ali Yolmo, Deeke Shaikh, Madiha Rupasinghe, Padmanayayakege Chamithra Dilshani Patel, Achint A |
author_facet | Lingas, Elvina Mulayamkuzhiyil Saju, Jiya Abdulqader, Mohammed Ali Yolmo, Deeke Shaikh, Madiha Rupasinghe, Padmanayayakege Chamithra Dilshani Patel, Achint A |
author_sort | Lingas, Elvina |
collection | PubMed |
description | Background: Hemolytic uremic syndrome (HUS) is a rare but challenging disease with varying degrees of mortality and prognosis. We aim to evaluate the trends and outcomes of hospitalizations due to HUS by utilizing a large population-based dataset. Methods: We derived a study cohort from the Nationwide Inpatient Sample (NIS) for the years 2007-2018. Our primary outcomes were in-hospital mortality, discharge disposition, and predictors of poor outcomes. We then utilized the Cochran Armitage trend test and multivariable survey logistic regression models to analyze the trends, outcomes, and predictors. Results: A total of 8043 hospitalizations ranging from age zero to above 65 years of age occurred due to HUS from 2007-2018. The number of hospitalizations with HUS increased steadily from 528 in 2007 to 800 in 2013, but afterwards, we noticed a steady decline to 620 in 2018. Additionally, trends of in-hospital mortality slowly increased over the study period but we noticed a decline in the rate of discharge to skilled nursing facilities (SNFs). Furthermore, in multivariable regression analysis, predictors of increased mortality in hospitalized HUS patients were advanced age (95%CI: 1.221-1.686; p-value <0.0001) and requirement for dialysis (95%CI: 1.141-4.167; p-value: <0.0001). Advanced age >65 years (OR: 2.599, 95%CI: 1.406-4.803; p-value: 0.0023), as well as comorbidities such as diabetes mellitus and pulmonary circulatory diseases, which are under vascular events (OR: 1.467, 95%CI:1.075-2.000; p-value: 0.0156), were shown to have a higher rate of discharge to SNFs. Moreover, patients needing intravenous immunoglobulin (IVIG) and plasmapheresis had high odds of discharge to SNFs ((OR: 1.99, 95%CI: 1.307-3.03; p-value: 0.0013) and (OR: 5.509, 95%CI: 2.807- 10.809; p-value <0.0001), respectively), as well as smaller hospital bed size and hospital type (OR: 1.849, 95%CI: 1.142-2.993; p-value: 0.012). Conclusion: In this national representative study, we observed a total decrease in hospitalizations as well as discharge to SNFs; however we saw an increase in inpatient mortality. We also identified multiple predictors significantly associated with increased mortality, some of which are potentially modifiable and can be points of interest for future studies. |
format | Online Article Text |
id | pubmed-9825057 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-98250572023-01-09 Trends and Outcomes of Hospitalizations Due to Hemolytic Uremic Syndrome: A National Perspective Lingas, Elvina Mulayamkuzhiyil Saju, Jiya Abdulqader, Mohammed Ali Yolmo, Deeke Shaikh, Madiha Rupasinghe, Padmanayayakege Chamithra Dilshani Patel, Achint A Cureus Internal Medicine Background: Hemolytic uremic syndrome (HUS) is a rare but challenging disease with varying degrees of mortality and prognosis. We aim to evaluate the trends and outcomes of hospitalizations due to HUS by utilizing a large population-based dataset. Methods: We derived a study cohort from the Nationwide Inpatient Sample (NIS) for the years 2007-2018. Our primary outcomes were in-hospital mortality, discharge disposition, and predictors of poor outcomes. We then utilized the Cochran Armitage trend test and multivariable survey logistic regression models to analyze the trends, outcomes, and predictors. Results: A total of 8043 hospitalizations ranging from age zero to above 65 years of age occurred due to HUS from 2007-2018. The number of hospitalizations with HUS increased steadily from 528 in 2007 to 800 in 2013, but afterwards, we noticed a steady decline to 620 in 2018. Additionally, trends of in-hospital mortality slowly increased over the study period but we noticed a decline in the rate of discharge to skilled nursing facilities (SNFs). Furthermore, in multivariable regression analysis, predictors of increased mortality in hospitalized HUS patients were advanced age (95%CI: 1.221-1.686; p-value <0.0001) and requirement for dialysis (95%CI: 1.141-4.167; p-value: <0.0001). Advanced age >65 years (OR: 2.599, 95%CI: 1.406-4.803; p-value: 0.0023), as well as comorbidities such as diabetes mellitus and pulmonary circulatory diseases, which are under vascular events (OR: 1.467, 95%CI:1.075-2.000; p-value: 0.0156), were shown to have a higher rate of discharge to SNFs. Moreover, patients needing intravenous immunoglobulin (IVIG) and plasmapheresis had high odds of discharge to SNFs ((OR: 1.99, 95%CI: 1.307-3.03; p-value: 0.0013) and (OR: 5.509, 95%CI: 2.807- 10.809; p-value <0.0001), respectively), as well as smaller hospital bed size and hospital type (OR: 1.849, 95%CI: 1.142-2.993; p-value: 0.012). Conclusion: In this national representative study, we observed a total decrease in hospitalizations as well as discharge to SNFs; however we saw an increase in inpatient mortality. We also identified multiple predictors significantly associated with increased mortality, some of which are potentially modifiable and can be points of interest for future studies. Cureus 2022-12-08 /pmc/articles/PMC9825057/ /pubmed/36628001 http://dx.doi.org/10.7759/cureus.32315 Text en Copyright © 2022, Lingas et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Internal Medicine Lingas, Elvina Mulayamkuzhiyil Saju, Jiya Abdulqader, Mohammed Ali Yolmo, Deeke Shaikh, Madiha Rupasinghe, Padmanayayakege Chamithra Dilshani Patel, Achint A Trends and Outcomes of Hospitalizations Due to Hemolytic Uremic Syndrome: A National Perspective |
title | Trends and Outcomes of Hospitalizations Due to Hemolytic Uremic Syndrome: A National Perspective |
title_full | Trends and Outcomes of Hospitalizations Due to Hemolytic Uremic Syndrome: A National Perspective |
title_fullStr | Trends and Outcomes of Hospitalizations Due to Hemolytic Uremic Syndrome: A National Perspective |
title_full_unstemmed | Trends and Outcomes of Hospitalizations Due to Hemolytic Uremic Syndrome: A National Perspective |
title_short | Trends and Outcomes of Hospitalizations Due to Hemolytic Uremic Syndrome: A National Perspective |
title_sort | trends and outcomes of hospitalizations due to hemolytic uremic syndrome: a national perspective |
topic | Internal Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9825057/ https://www.ncbi.nlm.nih.gov/pubmed/36628001 http://dx.doi.org/10.7759/cureus.32315 |
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