Background This study aims to compare outcomes of hospitalizations of granulomatosis with polyangiitis (GPA) with and without renal involvement. The primary outcome was inpatient mortality, whereas secondary outcomes were hospital length of stay (LOS) and total hospital charge. Methods Data were abstracted from the National Inpatient Sample (NIS) 2016 and 2017 databases. The NIS was searched for GPA hospitalizations with and without renal involvement as the principal or secondary diagnosis using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10) codes. GPA hospitalizations for adult patients from the above groups were identified. Multivariate logistic and linear regression analyses were used to adjust for possible confounders for the primary and secondary outcomes, respectively. Results There were more than 71 million discharges included in the combined 2016 and 2017 NIS database, of which 23,670 were for adult patients who had either a principal or secondary ICD-10 code for GPA, and 8,265 (34.92%) of these GPA hospitalizations had renal involvement. Hospitalizations for GPA with renal involvement had similar inpatient mortality (3.8% vs. 3.7%; adjusted OR: 1.14; 95% CI: 0.84-1.56; p=0.406) compared to those without renal involvement. GPA with renal involvement hospitalizations had an increase in adjusted mean LOS of 1.36 days (95% CI: 0.82-1.91; p=0.0001) compared to those without renal involvement. GPA with renal involvement hospitalizations had an increase in adjusted total hospital charges of $18,723 (95% CI: 9,595-27,852; p=0.0001) compared to those without renal involvement. Conclusions GPA with renal involvement hospitalizations had similar inpatient mortality compared to those without renal involvement. However, LOS and total hospital charges were greater in those with renal involvement.

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Left ventricular noncompaction (LVNC) is a relatively rare myocardial disorder which is characterized by trabeculations and deep intertrabecular recesses within the left ventricle. LVNC is often asymptomatic but may present with heart failure, arrhythmias, or systemic thromboembolism. Uncommonly, patients with LVNC can present with syncope. In this article, we report one such presentation of this rare medical condition.

This study aimed to compare outcomes of systemic sclerosis (SSc) hospitalizations with and without lung involvement. The primary outcome was inpatient mortality while secondary outcomes were hospital length of stay (LOS) and total hospital charge. Data were abstracted from the National Inpatient Sample (NIS) 2016 and 2017 database. This database is the largest collection of inpatient hospitalization data in the USA. The NIS was searched for SSc hospitalizations with and without lung involvement as principal or secondary diagnosis using International Classification of Diseases 10th Revision (ICD-10) codes. SSc hospitalizations for patients aged ≥18 years from the above groups were identified. Multivariate logistic and linear regression analysis was used to adjust for possible confounders for the primary and secondary outcomes, respectively. There were over 71 million discharges included in the combined 2016 and 2017 NIS database. 62,930 hospitalizations were for adult patients who had either a principal or secondary ICD-10 code for SSc. 5095 (8.10%) of these hospitalizations had lung involvement. Lung involvement group had greater inpatient mortality (9.04% vs 4.36%, adjusted OR 2.09, 95% CI 1.61 to 2.73, p<0.0001), increase in mean adjusted LOS of 1.81 days (95% CI 0.98 to 2.64, p<0.0001), and increase in mean adjusted total hospital charge of $31,807 (95% CI 14,779 to 48,834, p<0.0001), compared with those without lung involvement. Hospitalizations for SSc with lung involvement have increased inpatient mortality, LOS and total hospital charge compared with those without lung involvement. Collaboration between the pulmonologist and the rheumatologist is important in optimizing outcomes of SSc hospitalizations with lung involvement.

BackgroundLong-term longitudinal studies on giant cell arteritis (GCA) hospitalizations are limited. Here we aim to fill gaps in knowledge by analyzing longitudinal trends of GCA hospitalizations over the last two decades in the United States (U.S.). Materials and methodsWe performed a 21-year longitudinal trend analysis of GCA hospitalizations using data obtained from the National Inpatient Sample (NIS) database between 1998 and 2018. Using the NIS database, we searched for hospitalizations for patients aged ≥ 50 years with a principal diagnosis of GCA using ICD billing codes. The principal diagnosis was the main reason for hospitalization. We used all hospitalizations in patients without GCA aged ≥50 years as the control population. Multivariable logistic and linear regression analysis was utilized to calculate the adjusted p-trend for outcomes of interest. ResultsThe incidence of GCA hospitalization remained stable at about one per 100,000 U.S. persons throughout the study period. There was no statistically significant change in the inpatient mortality for the GCA group during the study period (adjusted p-trend=0.111). In comparison, inpatient mortality reduced from 4.4% to 3.1% from 1998 to 2018 (adjusted p-trend <0.0001) in the control group. The proportion of whites reduced, while the proportion of racial minorities increased over time in both the GCA and control groups. ConclusionThe non-GCA control population saw significant reductions in mortality over time, but unfortunately, the GCA group did not see such improvements. More research into additional treatment modalities for inpatient GCA management may help improve mortality.