Hidradenitis suppurativa (HS) is a clinical condition characterized by the formation of painful lumps under the skin. It often affects intertriginous areas like armpits and groin. There is a paucity of contemporary data on patient and hospital-level characteristics of HS in the United States. We analyzed the Nationwide Inpatient Sample (NIS) for retrospective analysis to calculate the frequency and yearly rates of HS hospitalizations, demographic variations, rates of comorbidities, and length of stay. The rate of hospitalizations with HS as a primary diagnosis increased from 7.9 per 100,000 all-cause hospitalizations in 2008 to 11.6 per 100,000 all-cause hospitalizations in 2017 (p < 0.0001). The mean age ± standard error of hospitalized patients was 39.5 ± 0.2 years. The age group of 18-34 years was the most affected. Women showed a higher preponderance of the disease than men (56.6% vs. 43.5%, p < 0.0001). The Black race was the most affected out of all the racial groups (59.9%). Most hospitalizations were in large, urban teaching hospitals. Hypertension (34.9%), skin and subcutaneous tissue infections (26.5%), and diabetes mellitus (25.9%) were the most common comorbidities. Out of the total hospitalizations with HS, 12.7% were found to have a major or extreme loss of function and 3.5% were at a major or extreme likelihood of dying. HS disproportionately affects young adults, women, and Black patients. A significant proportion of these patients are at a major risk of major loss of bodily function or death. Prospective studies are needed to identify the risk factors for hospitalizations in these patient populations and devise appropriate prevention and treatment strategies.
This retrospective study was conducted to analyze the temporal trends, predictors, and impact of disseminated intravascular coagulation (DIC) on outcomes among septicemic patients using a nationally representative database. We derived data from the National Inpatient Sample (NIS) for the years 2008-2017 for adult hospitalizations due to sepsis. The primary outcomes were in-hospital mortality and discharge to facility. The Cochran-Armitage test and multivariable survey logistic regression models were used to analyze the data. Out of 12,820,000 hospitalizations due to sepsis, 153,181 (1.18%) were complicated by DIC. The incidence of DIC decreased from 2008 to 2017. In multivariable regression analysis, demographics and comorbidities were associated with higher odds of DIC. During the study period, in-hospital mortality among patients with sepsis decreased, but the attributable risk percent of in-hospital mortality due to DIC increased. We observed similar trends for discharge to facility; however, the adjusted odds of discharge to facility due to DIC remained stable over the study period. Although the incidence of sepsis complicated by DIC decreased, the attributable in-hospital mortality rate due to DIC increased during the study period. We identified several predictors associated with the development of DIC in sepsis, some of which are potentially modifiable.
Clostridium difficile infection (CDI) is one of the rising public health threats in the United States. It has imposed significant morbidity and mortality in the elderly population. However, the burden of the disease in the young population is unclear. This study aimed to identify hospitalization trends and outcomes of CDI in the young population. We obtained data from the National (Nationwide) Inpatient Sample (NIS) for hospitalizations with CDI between 2007 and 2017. We used the International Classification of Diseases Ninth Edition-Clinical Modification (ICD-9-CM) and ICD-10-CM to identify CDI and other diagnoses of interest. The primary outcome of our study was to identify the temporal trends and demographic characteristics of patients aged less than 50 years old hospitalized with CDI. The secondary outcomes were in-hospital mortality, length of hospital stay (LOS), and discharge dispositions. We utilized the Cochran Armitage trend test and multivariable survey logistic regression models to analyze the trends and outcomes. From 2007 to 2017, CDI was present among 1,158,047 hospitalized patients. The majority (84.04%) of the patients were ≥50 years old versus 15.95% of patients <50 years old. From 2007 to 2017, there was a significant increase in CDI among <50-year-old hospitalized patients (12.6% from 2007 to 18.1% in 2017; p < 0.001). In trend analysis by ethnicities, among patients <50 years old, there was an increasing trend in Caucasians (63.9% versus 67.9%; p < 0.001) and Asian females (58.4% versus 62.6%; p < 0.001). We observed an increased trend of discharge to home (91.3% vs 95.8%; p < 0.001) in association with a decrease in discharge to facility (8.3% vs 4%; p < 0.001). The average LOS from 2007 to 2017 was 5 ± 0.03 days, which remained stable during the study period. The proportion of young (<50 years old) hospitalized patients with CDI has been steadily increasing over the past decade. Our findings might represent new epidemiological trends related to non-traditional risk factors. Future CDI surveillance should extend to the young population to confirm our findings, and the study of emerging risk factors is required to better understand the increasing CDI hospitalization in the young population.
30 June 2023 in SN Comprehensive Clinical Medicine