Palliative Care in Ruptured Aortic Aneurysm in the United States: A Retrospective Analysis of Nationwide Inpatient Sample Database

Ando, Tomo; Adegbala, Oluwole; Uemura, Takeshi; Ashraf, Said; Akintoye, Emmanuel; Pahuja, Mohit; Afonso, Luís; Briasoulis, Αlexandros; Takagi, Hisato

doi:10.1177/0003319720917239

Cited by 6 publications

(7 citation statements)

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“…The present meta-analysis provided an updated overview on the association between egg consumption and CVD risk and mortality: compared to previous meta-analyses, we included the highest number of cohorts reviewed to date, several dose–response analyses for the investigated outcomes, a detailed investigation for potential confounding factors by studying subgroups and stratifying the analyses, and we attempted an evaluation of the overall evidence. Previous meta-analyses reported rather mixed results, with no association with stroke risk [ 55 ], decreased risk of stroke and no association with CHD [ 56 , 57 ], decreased risk of CHD [ 58 ], no association with CVD risk [ 59 ], increased risk of heart failure [ 60 , 61 ],compared to these studies, our analysis is more complete and provides a general more in depth analysis of level of evidence. We generally found no strong association with either increased or decreased risk of cardiovascular outcomes following the habitual consumption of eggs (i.e., one egg per day compared to no intake), with exception of risk of heart failure, which resulted higher especially in men from US cohorts.…”

Section: Discussionmentioning

confidence: 86%

Egg consumption and cardiovascular risk: a dose–response meta-analysis of prospective cohort studies

et al. 2020

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Purpose Cardiovascular disease (CVD) is a leading cause of mortality globally and is strongly influenced by dietary risk factors. The aim was to assess the association between egg consumption and risk of CVD risk/mortality, including coronary heart disease (CHD), stroke, and heart failure. Methods MEDLINE, Embase, and Web of Science databases were searched through April 2020 for prospective studies. Two independent reviewers screened and extracted the data through standardized methods. Size effects were calculated as summary relative risks (SRRs) in a dose-response fashion through random-effects meta-analyses. Results Thirty-nine studies including nearly 2 million individuals and 85,053 CHD, 25,103 stroke, 7536 heart failure, and 147,124 CVD cases were included. The summary analysis including 17 datasets from 14 studies conducted on CVD (incidence and/or mortality) showed that intake of up to six eggs per week is inversely associated with CVD events, when compared to no consumption [for four eggs per week, SRR = 0.95 (95% CI: 0.90; 1.00)]; a decreased risk of CVD incidence was observed for consumption of up to one egg per day [SRR = 0.94 (95% CI: 0.89; 0.99)]. The summary analysis for CHD incidence/mortality including 24 datasets from 16 studies showed a decreased risk up to two eggs per week [(SRR = 0.96 (95% CI: 0.91; 1.00)]. No associations were retrieved with risk of stroke. The summary analysis for heart failure risk including six datasets from four studies showed that intake of one egg per day was associated with increased risk raising for higher intakes compared to no consumption [for 1 egg per day, SRR = 1.15 (95% CI:1.02; 1.30)]. After considering GRADE criteria for strength of the evidence, it was rated low for all outcomes but stroke, for which it was moderate (yet referring to no risk). Conclusion There is no conclusive evidence on the role of egg in CVD risk, despite the fact that higher quality studies are warranted to obtain stronger evidence for a possible protection of CVD associated with moderate weekly egg consumption compared to no intake; equally, future studies may strengthen the evidence for increased heart failure risk associated with high regular egg consumption.

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Section: Discussionmentioning

confidence: 86%

Egg consumption and cardiovascular risk: a dose–response meta-analysis of prospective cohort studies

et al. 2020

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“…The lower palliative care consultation utilization in younger patients, non-White race, lower income patient and smaller/non-teaching hospitals has been reported in previous studies with other medical issues. 9,21 Though our study does not identify subsets of patients that would benefit most from palliative care consultation, there is likely room to improve patient-selection for appropriate palliative care consultation in patients with Staphylococcus aureus bacteremia. In addition, a recent study revealed that Staphylococcus aureus bacteremia leads to a significant impact on the quality of life among survivors.…”

Section: Discussionmentioning

confidence: 97%

“…A similar study demonstrated that palliative care consultation was placed in 11 and 15% of patients with ST-segment elevation myocardial infarction and abdominal aortic rupture, respectively. 9,20 The lower rate of palliative care consultation in Staphylococcus aureus bacteremia may be explained by infection being viewed as more treatable (with antibiotics) than other conditions considered to be irreversible. However, palliative care consultation was used in only one third of Staphylococcus aureus bacteremia patients who died during their hospitalization (34% of 12971; 4314 patients).…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…The role of palliative care consultation in patients with Staphylococcus aureus bacteremia is incompletely elucidated despite the high mortality and morbidity associated with Staphylococcus aureus bacteremia. 8,9 We examined the frequency of utilization of palliative care consultation and factors associated with palliative care consultation in Staphylococcus aureus bacteremia patients in the United States.…”

Section: Introductionmentioning

confidence: 99%

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Palliative care consultation in patients with Staphylococcus aureus bacteremia

et al. 2021

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Background: Palliative care consultation has shown benefits across a wide spectrum of diseases, but the utility in patients with Staphylococcus aureus bacteremia remains unclear despite its high mortality. Aim: To examine the frequency of palliative care consultation and factors associated with palliative care consult in Staphylococcus aureus bacteremia patients in the United States. Design: A population-based retrospective analysis using the Nationwide Inpatient Sample database in 2014, compiled by the Healthcare Costs and Utilization Project of the Agency for Healthcare Research and Quality. Setting/subjects: All inpatients with a discharge diagnosis of Staphylococcus aureus bacteremia (ICD-9-CM codes; 038.11 and 038.12). Measurements: Palliative care consultation was identified using ICD-9-CM code V66.7. Patients’ baseline characteristics and outcomes were compared between those with and without palliative care consult. Results: A total of 111,320 Staphylococcus aureus bacteremia admissions were identified in 2014. Palliative care consult was observed in 8140 admissions (7.3%). Palliative care consultation was associated with advanced age, white race, comorbidities, higher income, teaching/urban hospitals, Midwest region, Methicillin-resistant Staphylococcus aureus bacteremia and the lack of echocardiogram. Palliative care consult was also associated with shorter but more expensive hospitalizations. Crude mortality was 53% (4314/8140) among admissions with palliative care consult and 8% (8357/10,3180) among those without palliative care consult ( p < 0.001). Conclusions: Palliative care consultation was infrequent during the management of Staphylococcus aureus bacteremia, and a substantial number of patients died during their hospitalizations without palliative care consult. Given the reported benefit in other medical conditions, palliative care consultation may have a role in Staphylococcus aureus bacteremia. Selecting patients who may benefit the most should be explored.

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Transition from Open Repair to Endovascular Aneurysm Repair for Rupture Aortic Aneurysms throughout a 16-Year Period of Time in a Single Tertiary Center

Spanos,

Volakakis,

Kouvelos

et al. 2024

Annals of Vascular Surgery

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Palliative Care in Ruptured Aortic Aneurysm in the United States: A Retrospective Analysis of Nationwide Inpatient Sample Database

Cited by 6 publications

References 37 publications

Egg consumption and cardiovascular risk: a dose–response meta-analysis of prospective cohort studies

Egg consumption and cardiovascular risk: a dose–response meta-analysis of prospective cohort studies

Palliative care consultation in patients with Staphylococcus aureus bacteremia

Transition from Open Repair to Endovascular Aneurysm Repair for Rupture Aortic Aneurysms throughout a 16-Year Period of Time in a Single Tertiary Center

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