Trends in Management and Outcomes of ST-Elevation Myocardial Infarction in Patients With End-Stage Renal Disease in the United States

Gupta, Tanush; Harikrishnan, Prakash; Kolte, Dhaval; Khera, Sahil; Subramanian, Kathir; Mujib, Marjan; Masud, Arif; Palaniswamy, Chandrasekar; Sule, Sachin; Jain, Diwakar; Ahmed, Ali; Lanier, Gregg M.; Cooper, Howard A.; Frishman, William H.; Bhatt, Deepak L.; Fonarow, Gregg C.; Panza, Julio A.; Aronow, Wilbert S.

doi:10.1016/j.amjcard.2015.01.529

Cited by 32 publications

(27 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The NIS is sponsored by the Agency for Healthcare Research and Quality (AHRQ) as a part of the Healthcare Cost and Utilization Project (HCUP) and and is used by researchers and policymakers to analyze national trends in healthcare utilization and outcomes. 13,14 NIS is the largest all-payer inpatient care M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 4 database publicly available in the U.S. and includes data from over 8 million hospital stays from ~ 1,000 hospitals, approximating a 20% stratified sample of discharges from U.S. hospitals. Data are drawn from "all non-Federal, short-term, general, and other specialty hospitals" in participating states (n=46 in 2011), representing over 95% of the U.S. population.…”

Section: Methodsmentioning

confidence: 99%

Relation of Obesity to Survival After In-Hospital Cardiac Arrest

Gupta

Kolte

Mohananey

et al. 2016

The American Journal of Cardiology

Self Cite

View full text Add to dashboard Cite

Section: Methodsmentioning

confidence: 99%

Relation of Obesity to Survival After In-Hospital Cardiac Arrest

Gupta

Kolte

Mohananey

et al. 2016

The American Journal of Cardiology

Self Cite

View full text Add to dashboard Cite

“…The CKD and ESRD groups were mutually exclusive; patients with ICD-9-CM codes both for CKD and ESRD were assigned to the ESRD group and patients with codes for CKD but not ESRD were assigned to the CKD group. This approach has been used by previous studies using the NIS database to accurately identify patients with CKD or ESRD 13,14. In administrative databases, ICD-9-CM coding for RI has been shown to have a sensitivity of 81.9%, specificity of 98.6%, positive predictive value of 71.2%, and negative predictive value of 99.2% 15.…”

Section: Methodsmentioning

confidence: 99%

Association of Chronic Renal Insufficiency With In‐Hospital Outcomes After Percutaneous Coronary Intervention

Gupta

Paul

Kolte

et al. 2015

JAHA

Self Cite

View full text Add to dashboard Cite

BackgroundThe association of chronic renal insufficiency with outcomes after percutaneous coronary intervention (PCI) in the current era of drug-eluting stents and modern antithrombotic therapy has not been well characterized.Methods and ResultsWe queried the 2007–2011 Nationwide Inpatient Sample databases to identify all patients aged ≥18 years who underwent PCI. Multivariable logistic regression was used to compare in-hospital outcomes among patients with chronic kidney disease (CKD), patients with end-stage renal disease (ESRD), and those without CKD or ESRD. Of 3 187 404 patients who underwent PCI, 89% had no CKD/ESRD; 8.6% had CKD; and 2.4% had ESRD. Compared to patients with no CKD/ESRD, patients with CKD and patients with ESRD had higher in-hospital mortality (1.4% versus 2.7% versus 4.4%, respectively; adjusted odds ratio for CKD 1.15, 95% CI 1.12 to 1.19, P<0.001; adjusted odds ratio for ESRD 2.29, 95% CI 2.19 to 2.40, P<0.001), higher incidence of postprocedure hemorrhage (3.5% versus 5.4% versus 6.0%, respectively; adjusted odds ratio for CKD 1.21, 95% CI 1.18 to 1.23, P<0.001; adjusted odds ratio for ESRD 1.27, 95% CI 1.23 to 1.32, P<0.001), longer average length of stay (2.9 days versus 5.0 days versus 6.4 days, respectively; P<0.001), and higher average total hospital charges ($60 526 versus $77 324 versus $97 102, respectively; P<0.001). Similar results were seen in subgroups of patients undergoing PCI for acute coronary syndrome or stable ischemic heart disease.ConclusionsIn patients undergoing PCI, chronic renal insufficiency is associated with higher in-hospital mortality, higher postprocedure hemorrhage, longer average length of stay, and higher average hospital charges.

show abstract

“…As there is no occurrence of acute renal dysfunction in the ESRD cohort, the incidence of severe sepsis in the general population may be artificially overinflated. The ICD-9-CM codes used to identify patients on maintenance dialysis have not been validated but have been used in literature to identify ESRD patients using administrative database [23,24]. Our estimates of decrements in severe sepsis-related mortality in the ESRD cohort might only present a phenomenon where in-hospital mortality is shifted to the skilled nursing facility environment following a hospital discharge.…”

Section: Discussionmentioning

confidence: 84%

Trends and Outcomes of Severe Sepsis in Patients on Maintenance Dialysis

et al. 2016

View full text Add to dashboard Cite

Background: Though the incidence of severe sepsis is rising, there is a lack of contemporary information regarding the epidemiology and outcomes of severe sepsis in those on maintenance dialysis. The objectives of this study were to measure the incidence and outcomes of severe sepsis in those on maintenance dialysis. Methods: Using data from Nationwide Inpatient Sample database from 2005 to 2010, we included all hospitalizations of adults with severe sepsis based on the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. Those on maintenance dialysis were identified by ICD-9-CM codes. We calculated incidence of severe sepsis and mortality. We used logistic regression to assess independent effect of maintenance dialysis status on mortality. Results: Of the estimated 5,000,152 hospitalizations with severe sepsis, 322,734 (6.4%) were on maintenance dialysis. The unadjusted incidence of severe sepsis was 145.4 per 1,000 in those on maintenance dialysis in comparison to 3.5 per 1,000 in the general population. Mortality was higher in those with severe sepsis (30.3 vs. 26.2%; p < 0.001). Maintenance dialysis is an independent predictor of death in those with severe sepsis (OR 1.26; 95% CI 1.23-1.29). Conclusions: Hospitalizations with severe sepsis are more prevalent and associated with poor outcomes in those on maintenance dialysis.

show abstract

Trends in Management and Outcomes of ST-Elevation Myocardial Infarction in Patients With End-Stage Renal Disease in the United States

Cited by 32 publications

References 30 publications

Relation of Obesity to Survival After In-Hospital Cardiac Arrest

Relation of Obesity to Survival After In-Hospital Cardiac Arrest

Association of Chronic Renal Insufficiency With In‐Hospital Outcomes After Percutaneous Coronary Intervention

Trends and Outcomes of Severe Sepsis in Patients on Maintenance Dialysis

Contact Info

Product

Resources

About