Comparison of Outcomes in Patients Having Acute Myocardial Infarction With Versus Without Sickle-Cell Anemia

Ogunbayo, Gbolahan; Misumida, Naoki; Olorunfemi, Odunayo; Elbadawi, Ayman; Saheed, Deola; Messerli, Adrian W.; Elayi, Claude S.; Smyth, Susan S.

doi:10.1016/j.amjcard.2017.07.108

Cited by 20 publications

(12 citation statements)

References 21 publications

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“…The key characteristics of 15 included studies are presented in Table 3. [30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] Five retrospective studies evaluated electronic medical records (EMRs) [33][34][35]38,42 and nine studies were retrospective database analyses. [30][31][32]36,37,39,40,43,44 One study used data from the Sickle Cell Data Collection Program, a registry collecting data from Georgia and California.…”

Section: Overview Of Search Resultsmentioning

confidence: 99%

“…[30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] Five retrospective studies evaluated electronic medical records (EMRs) [33][34][35]38,42 and nine studies were retrospective database analyses. [30][31][32]36,37,39,40,43,44 One study used data from the Sickle Cell Data Collection Program, a registry collecting data from Georgia and California. 41 Fourteen studies reported on HCRU, 30,[32][33][34][35][36][37][38][39][40][41][42][43][44] while one reported direct medical costs.…”

Section: Overview Of Search Resultsmentioning

confidence: 99%

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<p>Patient-Reported Outcomes and Economic Burden of Adults with Sickle Cell Disease in the United States: A Systematic Review</p>

Lee

Vania

Bhor

et al. 2020

IJGM

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Purpose: To systematically estimate the patient-reported outcomes (PROs) and economic burden of sickle cell disease (SCD) among adults in the United States (US). Patients and Methods: Two systematic literature reviews (SLRs), one each for the PROs and economic topics, were performed using MEDLINE and Embase to identify observational studies of adults with SCD. Included studies were published between 2007 and 2018 and evaluated health-related quality of life (HRQL), function, healthcare resource utilization (HCRU), or costs. Given the high degree of clinical and methodological heterogeneity, findings were summarized qualitatively. Results: The SLRs identified 7 studies evaluating the PROs and 15 studies evaluating the economic burden meeting the pre-specified selection criteria. The PRO evidence showed the prevalence of depression and anxiety to be 21-33% and 7-36%, respectively, in adults with SCD. The mean SF-36 physical summary scores ranged from 33.6 to 59.0 and from 46.3 to 61.5 for the mental summary scores. Overall HRQL for adults with SCD was poor and significantly worse in those with opioid use. Adult SCD patients were found to have varying rates of emergency department (ED) utilization (0.3-3.5 annual ED visits), hospitalizations (0.5-27.9 per patient per year), and/or readmission (12-41%). Key factors associated with significant HCRU were age, dental infection, and SCD-related complications. SCD specialized care settings and SCD intensive management strategy were reported to significantly decrease the number of hospitalizations. Conclusion: This systematic evidence synthesis found that disease burden measured by PROs and economic burden of SCD on adults in the US are substantial despite the availability of approved SCD treatments during 2007-2018. The use of hydroxyurea, optimal management with opioids, and employing intensive treatment strategies may help decrease the overall burden to patients and healthcare systems. Published data on costs associated with SCD are limited and highlight the need for more economic studies to characterize the full burden of the disease.

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Section: Overview Of Search Resultsmentioning

confidence: 99%

Section: Overview Of Search Resultsmentioning

confidence: 99%

<p>Patient-Reported Outcomes and Economic Burden of Adults with Sickle Cell Disease in the United States: A Systematic Review</p>

Lee

Vania

Bhor

et al. 2020

IJGM

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“…Data were obtained from the National Inpatient Sample (NIS) database; the search strategy has been described in detail elsewhere . Briefly, the NIS is the largest publicly available US inpatient healthcare database that contains more than 7 million admissions per year along with data, such as demographics, diagnosis procedures, and hospital outcomes.…”

Section: Methodsmentioning

confidence: 99%

“…Data were obtained from the National Inpatient Sample (NIS) database; the search strategy has been described in detail elsewhere. 20 Briefly, the NIS is the largest publicly available US inpatient healthcare database that contains more than 7 million admissions per year along with data, such as demographics, diagnosis procedures, and hospital outcomes. The database is publicly available and does not contain any of the 18 HIPAA identifiers; therefore, the office of research integrity in our institution deemed that institutional review board approval was not necessary.…”

Section: Search Strategymentioning

confidence: 99%

Safety of catheter ablation for atrial fibrillation in the octogenarian population

Romero

Ogunbayo²,

Elayi³

et al. 2019

Cardiovasc electrophysiol

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Introduction Catheter ablation (CA) has been shown to be an effective treatment for atrial fibrillation (AF). The complication rates and outcomes among octogenarians remain poorly studied. We aimed to compare trends, morbidity, and mortality associated with CA for AF among octogenarians versus those less than 80 years old. Methods Using weighted sampling from the National Inpatient Sample database, we identified patients with a primary diagnosis of AF and a primary procedure of CA (2004‐2013). Our primary outcome was mortality. Secondary outcomes included incidence of major and minor complications. Results Among 86,119 patients who underwent CA for AF, 3,482 were 80 years old or older. Complications were significantly more frequent in octogenarians; [16.2% (564 of 3,482) versus 9.8% (8,092 of 82,637), P < 0.001]. Of note, there was no significant difference for the composite of major complications; [3.6% (124 of 3482) in octogenarians versus 2.8% (2286 of 82637), P = 0.20]. The total mortality rate was not significant in a multivariate regression analysis (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.35‐2.64; P = .94). The presence of chronic renal failure (OR, 4.19; 95% CI, 2.75‐6.36; P < 0.001), anemia (OR, 1.75; 95% CI, 1.03‐2.97; P = .04), and chronic pulmonary disease (OR, 1.75; 95% CI, 1.11‐2.62; P = .015) were predictors of major complications in octogenarians. Conclusion Catheter ablation for AF in octogenarians does not confer a higher mortality risk than in those less than 80 years old. The procedure is associated with a higher rate of overall complications but there was no difference in terms of major complications or death. The presence of anemia, CKD or pulmonary disease were predictors of major complications in octogenarians.

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“…We used NIS documentation, ICD codes, or the clinical classification software (CCS) coding, when applicable. The CCS categories have been used to group medical conditions in previous studies . The AHRQ describes a medical facility as a teaching hospital if it has an American Medical Association‐approved residency program, or if it was member of the Council of Teaching Hospitals (COTH), or had a ratio of full‐time intern/resident‐equivalents to beds of 0.25.…”

Section: Methodsmentioning

confidence: 99%

Temporal trends, characteristics and outcomes of fibrinolytic therapy for ST‐elevation myocardial infarction among patients 80 years or older

Ogunbayo

Misumida

Ayoub

et al. 2018

Cathet Cardio Intervent

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Background: Pharmacologic reperfusion therapy is a recommended and effective strategy in patients with ST-elevation myocardial infarction (STEMI) when percutaneous coronary intervention (PCI) is not available. This study investigates temporal trends and outcomes of fibrinolytic therapy (FT) in elderly patients with STEMI.Methods: Using the Nationwide Inpatient Sample database, we extracted patients ≥80 years a primary diagnosis of STEMI admitted between 2010 and 2014. Using ICD codes, we identified patients who underwent FT. We performed temporal trend analysis, then compared characteristics and inpatient outcomes in the FT group versus no-FT group. Our primary outcome of interest was hemorrhagic stroke (HS). We also assessed the impact of HS on mortality and discharge to skilled nursing facility (SNF).Results: Of the 917,307 patients with STEMI, 16.1% (n = 147,874) were aged 80 or older. Primary PCI was performed in 46.2%, 2.4% underwent FT, and 51.3% had neither pharmacologic nor mechanical revascularization. The rate of FT increased (1.9%-2.4%) in a nonlinear trend over the five years of the study. The FT group was eight times more likely to suffer HS (P < 0.001).FT was an independent predictor of HS (OR 7.90, 95% CI 4.36-14.30; P < 0.001), whether they underwent PCI or not. HS was an independent predictor of mortality and SNF discharge.Conclusion: FT in patients 80 years or older presenting with STEMI was associated with an eight-fold increase in HS and no associated mortality advantage, both with or without PCI.These data underscore the increased risk of FT in the elderly. K E Y W O R D S elderly, fibrinolysis, hemorrhagic stroke, ST-elevation myocardial infarction

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Comparison of Outcomes in Patients Having Acute Myocardial Infarction With Versus Without Sickle-Cell Anemia

Cited by 20 publications

References 21 publications

<p>Patient-Reported Outcomes and Economic Burden of Adults with Sickle Cell Disease in the United States: A Systematic Review</p>

<p>Patient-Reported Outcomes and Economic Burden of Adults with Sickle Cell Disease in the United States: A Systematic Review</p>

Safety of catheter ablation for atrial fibrillation in the octogenarian population

Temporal trends, characteristics and outcomes of fibrinolytic therapy for ST‐elevation myocardial infarction among patients 80 years or older

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