Lower eGFR at dialysis initiation is associated with lower mortality. Conditions at dialysis initiation explained excess 1-year mortality risk differently in patients who began dialysis at different levels of eGFR. Other factors likely contribute to the mortality of patients initiating dialysis at higher eGFR levels, and further study is needed.
The present findings confirm urban-rural differences in the reporting of associations between depressive symptoms, chronic medical conditions, and functional disability. For developing prevention programs on geriatric depression, it is critical to call more attention to chronic medical conditions, functional status, and social support of urban and rural elderly.
There is a lack of multi-center cost-identification studies for hematopoietic cell transplantation (HCT). We used a single longitudinal administrative claims database representing a national, commercially insured population to evaluate the feasibility of identifying HCT recipients and to establish a cohort of autologous and allogeneic HCT recipients to study inpatient and outpatient direct medical costs from transplant hospitalization through first 100 days post-transplantation. Using ICD-9 procedure and diagnosis codes, we identified 3,365 patients who had received their first transplant in the United States between 2007 and 2009 (autologous-1,678, allogeneic-1,320, graft source not specified-367). The median 100-day total costs for autologous HCT were $99,899 (interquartile range [IQR], $73,914–140,555) and for allogeneic HCT were $203,026 (IQR, $141,742–316,426). The majority of costs (>75%) occurred during the initial transplant hospitalization for both autologous and allogeneic HCT recipients. Costs were greater among pediatric (≤ 20 years) compared to adult (>20 years) recipients and this difference was more pronounced with allogeneic HCT. Using a claims database representing a national HCT population, we highlight the high costs associated with autologous and allogeneic HCT. Our study lays the foundation for using claims data for future research on economic aspects of HCT.
For long-term evaluation of THA patients, clinicians and health researchers should weight both measures equally and should also consider co-morbidities.
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