A recent study by Desai et al. (1) showed that the incidence and economic burden of hospitalizations due to diabetic ketoacidosis (DKA) in the U.S. increased between 2003 and 2014 (1). We sought to understand the most recent impact of the disease in the U.S. using the 2017 National Inpatient Sample (NIS) (www.hcup-us.ahrq .gov/nisoverview.jsp). A total of 220,340 patients were identified with a primary diagnosis of DKA (61.6 cases of DKA per 10,000 admissions) (Table 1). The incidence of DKA per 10,000 admissions was higher in males (71.2) than females (54.1), and the majority of DKA patients were covered by Medicaid (79,175 patients [36.0%], P , 0.01). Of all DKA patients, 53.3% were of ages 18-44 years. However, a higher incidence per 10,000 admissions was noted in patients of ages 1-17 years. The mean age of patients with DKA was 38.4 years. The total charges among DKA patients in 2017 were $6,757,748,178, with a mean of $30,836.19. The mean length of stay was 3.22 days. A total of 835 deaths were found among DKA patients, with a mortality rate of 0.38%. The overall mortality rate was higher among males admitted with DKA (40.5 deaths per 10,000 cases of DKA) than females (35.3 deaths per 10,000 cases of DKA). While most cases and deaths were recorded among whites (120,330 cases [56.5%], 435 deaths [53.7%]), the
To provide an estimate on the most recent burden of neonatal abstinence syndrome (NAS) in the United States. METHODS: The 2016 Kids' Inpatient Database, provided by the Healthcare Cost and Utilization Project and Agency for Healthcare Research and Quality and its partners, was used to identify patients with NAS in the United States. The data consisted of pediatric admissions from 4200 US hospitals recorded between January 1, 2016, and December 31, 2016. Data were converted to weighted form to project a national estimate on the possible number of neonates affected by NAS. Differences in sex, race, location, household income, primary payer form, length of stay, and total charges were studied. RESULTS: The sample contained 32 128 patients with NAS (0.8%), among whom 17 164 (53.5%) were boys and 14 935 (46.5%) were girls (P , .001); 23 027 (80.4%) were white (P , .001), and 13 583 (42.3%) were from the southern parts of the United States (P , .001). Medicaid covered 83.8% of patients, and 40.2% had an income within the first quartile of national averages (P , .001). The overall mean and median length of stay were 16.45 and 12.00 days, respectively, and the mean and median total charges were calculated as $79 937.
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