Outcomes after clipping and endovascular coiling for aneurysmal subarachnoid hemorrhage among dual-eligible beneficiaries

Ruiz, Kiara M. Corcoran; Perla, Krissia M. Rivera; Tang, Oliver Y.; Toms, Steven; Weil, Robert J.

doi:10.1016/j.jocn.2021.05.008

Cited by 5 publications

(2 citation statements)

References 35 publications

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“…Dual-eligibles have been previously identified as a high-resource utilization group experiencing poorer outcomes. [41][42][43][44][45][46] Due to lack of dual-payor reporting in the NIS beyond the year 2011, we were unable to adjust for dual-eligible status in our analysis. Lastly, Medicare coverage confers increased access to skilled nursing facilities and other enhanced care facilities compared to Medicaid and uninsured patients therefore increasing discharge to skilled nursing facilities in lieu of home discharge among patients in need of enhanced services.…”

Section: Discussionmentioning

confidence: 99%

Characterizing the Impact of Socioeconomic Status on Orbital Floor Reconstruction: A National Inpatient Sample (NIS) Analysis

Perla

Zeyl

Lopez

et al. 2022

Journal of Craniofacial Surgery

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Orbital floor fractures result in posterior globe displacement known as enophthalmos, and diplopia due to extraorbital soft tissue impingement. Surgical repair may involve the use of autolo-gous or synthetic materials. Previous studies have demonstrated a higher prevalence of orbital floor fractures among lower socioeconomic status (SES) populations. The authors aimed to characterize the impact of socioeconomic status on surgical management, outcomes, and use of synthetic orbital implant. The authors conducted a cross-sectional study of adult orbital floor fracture patients from 2002 to 2017 using the National Inpatient Sample. Among patients who underwent surgical treatment, our study found decreased synthetic orbital implant use among uninsured and Black patients and decreased home discharge among Medicare patients. There were no dif-ferences in orbital reconstruction. Further research is needed to elucidate possible mechanisms driving these findings.

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Section: Discussionmentioning

confidence: 99%

Characterizing the Impact of Socioeconomic Status on Orbital Floor Reconstruction: A National Inpatient Sample (NIS) Analysis

Perla

Zeyl

Lopez

et al. 2022

Journal of Craniofacial Surgery

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“…An additional sensitivity analysis was performed with 1:1 propensity matching between frail and nonfrail patients (Supplemental Digital Content 1, http:// links.lww.com/NEU/D300). [20][21][22][23][24] The results were reported as odds ratios for binary variables and percent change for continuous variables using a gamma log-link regression model idealized for analyzing rightskewed outcomes. Statistical significance was held at P < .05.…”

Section: Methodsmentioning

confidence: 99%

The Impact of Frailty on Traumatic Brain Injury Outcomes: An Analysis of 691 821 Nationwide Cases

et al. 2022

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BACKGROUND:Frailty, a decline in physiological reserve, prognosticates poorer outcomes for several neurosurgical conditions. However, the impact of frailty on traumatic brain injury outcomes is not well characterized.OBJECTIVE:To analyze the association between frailty and traumatic intracranial hemorrhage (tICH) outcomes in a nationwide cohort.METHODS:We identified all adult admissions for tICH in the National Trauma Data Bank from 2007 to 2017. Frailty was quantified using the validated modified 5-item Frailty Index (mFI-5) metric (range = 0-5), with mFI-5 ≥2 denoting frailty. Analyzed outcomes included in-hospital mortality, favorable discharge disposition, complications, ventilator days, and intensive care unit (ICU) and total length of stay (LOS). Multivariable regression assessed the association between mFI-5 and outcomes, adjusting for patient demographics, hospital characteristics, injury severity, and neurosurgical intervention.RESULTS:A total of 691 821 tICH admissions were analyzed. The average age was 57.6 years. 18.0% of patients were frail (mFI-5 ≥ 2). Between 2007 and 2017, the prevalence of frailty grew from 7.9% to 21.7%. Frailty was associated with increased odds of mortality (odds ratio [OR] = 1.36, P < .001) and decreased odds of favorable discharge disposition (OR = 0.72, P < .001). Frail patients exhibited an elevated rate of complications (OR = 1.06, P < .001), including unplanned return to the ICU (OR = 1.55, P < .001) and operating room (OR = 1.17, P = .003). Finally, frail patients experienced increased ventilator days (+12%, P < .001), ICU LOS (+11%, P < .001), and total LOS (+13%, P < .001). All associations with death and disposition remained significant after stratification for age, trauma severity, and neurosurgical intervention.CONCLUSION:For patients with tICH, frailty predicted higher mortality and morbidity, independent of age or injury severity.

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Brain tumor craniotomy outcomes for dual-eligible medicare and medicaid patients: a 10-year nationwide analysis

et al. 2022

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Outcomes after clipping and endovascular coiling for aneurysmal subarachnoid hemorrhage among dual-eligible beneficiaries

Cited by 5 publications

References 35 publications

Characterizing the Impact of Socioeconomic Status on Orbital Floor Reconstruction: A National Inpatient Sample (NIS) Analysis

Characterizing the Impact of Socioeconomic Status on Orbital Floor Reconstruction: A National Inpatient Sample (NIS) Analysis

The Impact of Frailty on Traumatic Brain Injury Outcomes: An Analysis of 691 821 Nationwide Cases

Brain tumor craniotomy outcomes for dual-eligible medicare and medicaid patients: a 10-year nationwide analysis

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