Epidemiology of Medial Ulnar Collateral Ligament Reconstruction: A 10-Year Study in New York State.

Background: Despite an increase in the prevalence of medial ulnar collateral ligament (UCL) reconstruction of the elbow in professional baseball and popularity within the media, there are no population-based studies examining the incidence of UCL reconstruction.

Purpose: To examine the epidemiological trends of UCL reconstruction on a statewide level over a 10-year period. The primary endpoint was the yearly rate of UCL reconstruction over time; secondary endpoints included patient demographics, institution volumes, and concomitant procedures on the ulnar nerve.

The use of large healthcare data sets in pursuit of a clinical question.

The use of large healthcare databases may be of interest to nurse practitioners who wish to answer clinical questions. This column will provide information about access to selected large healthcare databases, requirements for statistical software, and the skills required to utilize these databases.

Superior labrum anterior-to-posterior repair incidence: a longitudinal investigation of community and academic databases.

Background: Superior labrum anterior-to-posterior (SLAP) lesion repair is controversial regarding indications and potential complications.

Methods: Databases were used to determine the SLAP repair incidence compared with all orthopaedic procedures over a period of 10 years. In part A, the New York Statewide Planning and Research Cooperative System ambulatory surgery database was investigated from 2002 to 2009.

The rising incidence of acromioplasty.

Background: Acromioplasty is considered a technically simple procedure but has become controversial with regard to its indications and therapeutic value.

Methods: Two complementary databases were used to ascertain the frequency of acromioplasty over a recent span of time. In Part A, the New York Statewide Planning and Research Cooperative System (SPARCS) ambulatory surgery database was searched from 1996 to 2006 to identify all ambulatory surgery acromioplasties as well as all orthopaedic ambulatory surgery procedures.

The vulnerabilities of age: burns in children and older adults.

Background: Both children and older adults are thought to sustain burns serious enough to warrant hospitalization disproportionately more often than other age groups, but the incidence, injury characteristics, and outcome have not been precisely defined.

Methods: Patients hospitalized with a burn diagnosis were identified from hospital discharge data from California, Florida, New Jersey, and New York for the 5-year period 2000-2004.

Results: In those states, 60,024 residents were hospitalized with a diagnosis of burn and/or inhalation injury according to the International Classification of Diseases, 9th Revision, Clinical Modification diagnosis codes.

The epidemiology of slipped capital femoral epiphysis: an update.

The Kids' Inpatient Database, reflecting 6.70 million pediatric discharges in 1997 and 7.30 million in 2000, was coupled with the US Census Bureau data and was used to elicit the epidemiology of idiopathic slipped capital femoral epiphysis (SCFE) that occurred in children 9-16 years.

Acute renal failure in hospitalized patients with HIV: risk factors and impact on in-hospital mortality.

Background: Kidney disease is an increasingly important complication of HIV.

Objectives: To examine the incidence and predictors of acute renal failure before and after the introduction of HAART, and the impact of acute renal failure on in-hospital mortality in the post-HAART era.

Methods: Adults hospitalized in acute care hospitals in New York State during 1995 (pre-HAART) or 2003 (post-HAART) were identified from the state Planning and Research Cooperative System database.

The contribution of hospital volume, payer status, and other factors on the surgical outcomes of scoliosis patients: a review of 3,606 cases in the State of California.

While volume/outcomes relationships have been shown for several areas of orthopaedics, previous studies have not examined this relationship in the area of scoliosis surgery. The Office of Statewide Planning and Development (OSHPD) California inpatient discharge database was used for a retrospective review of all patients 25 years of age or younger with a diagnosis of scoliosis and a spinal fusion procedure from 1995 to 1999 (n = 3,606). Univariate and multivariate analyses were conducted to determine the effect of various factors on in-hospital mortality, surgical complications, reoperations, and length of stay (LOS).

The burden of acute renal failure in nonrenal solid organ transplantation.

Background: Recipients of nonrenal solid organ transplants are at risk for acute renal failure resulting from cardiac or hepatic failure, prolonged surgery, and nephrotoxic effects of immunosuppression. Single-center studies have suggested a variable incidence of acute renal failure in this population, with an associated increase in mortality. This study examines the incidence of acute renal failure and its associated mortality and morbidity in a modern multicenter cohort.

Do nurse practitioners make a difference in provision of health counseling in hospital outpatient departments?

Purpose: This study examined whether nurse practitioners (NPs) had any impact on the type and amount of health counseling provided during patient visits to hospital outpatient departments (OPDs).

Data Sources: This is a secondary data analysis of the National Hospital Ambulatory Medical Care Survey from 1997 to 2000. Only patient visits to hospital OPDs were included.

Clinical outcomes and secondary diagnoses for infants born with hypoplastic left heart syndrome.

Objective: To explore clinical outcomes and secondary diagnoses present at discharge for infants born with hypoplastic left heart syndrome (HLHS), from a national perspective.

Methods: We examined hospitalizations for infants < or =30 days of age who were born with HLHS, using hospital discharge data from the 1997 Kids Inpatient Database. To explore treatment choices, clinical outcomes, and resource use, we used International Classification of Diseases, 9th Revision, Clinical Modification diagnostic and procedure codes to classify discharges according to type of surgical intervention versus no surgical intervention.

Awareness of kidney disease in the US population: findings from the National Health and Nutrition Examination Survey (NHANES) 1999 to 2000.

Background: The prevalence of end-stage renal disease (ESRD) in the US population has been predicted to increase by 48% during the next decade and will pose a significant health cost burden. Early identification and treatment of chronic kidney disease (CKD) is necessary to delay progression from CKD to ESRD. CKD awareness among patients is crucial to early intervention programs, but its prevalence and characteristics in the noninstitutionalized US population are unknown.

Incidence of retinopathy of prematurity from 1996 to 2000: analysis of a comprehensive New York state patient database.

Objective: To determine the current incidence of retinopathy of prematurity (ROP) in New York state.

Design: Population-based cohort study.

Participants: Newborn infants (15 691) with initial hospital length of stay >28 days and date of discharge from January 1, 1996, to December 31, 2000.

A statewide experience with endovascular abdominal aortic aneurysm repair: rapid diffusion with excellent early results.

Objective: The purpose of this study was to compare survival and outcomes of endovascular versus open repair of abdominal aortic aneurysms (AAAs) in New York State (NYS).

Methods: We used the NYS discharge dataset Statewide Planning and Research Cooperative System (SPARCS) to analyze the outcomes of elective admission for nonruptured (International Classification of Diseases-9th revision [ICD-9] 441.4) open aneurysm repair (38.

Left ventricular assist devices as permanent heart failure therapy: the price of progress.

Background Data: The REMATCH trial evaluated the efficacy and safety of long-term left ventricular assist device (LVAD) support in stage D chronic end-stage heart failure patients. Compared with optimal medical management, LVAD implantation significantly improved the survival and quality of life of these terminally ill patients. To date, however, there have been no analyses of the cost related to the LVAD survival benefit.

Characteristics of patient visits to nurse practitioners in hospital outpatient departments.

Nurse practitioners (NPs) are the largest and the fastest growing groups among nonphysician practitioners in the United States. However, there has been lack of studies on the supply, demand, and use of nurse practitioners in hospital outpatient departments (OPDs) across the nation. Using the National Hospital Ambulatory Medical Care Survey (1997-2000), this study describes patient visits to NPs in general medicine, pediatrics, and obstetrics/gynecology clinics in hospitals across the nation.

Comparison of complications after transtrochanteric and posterolateral approaches for primary total hip arthroplasty.

For this study, 100 total hip arthroplasties (THAs) in a transtrochanteric approach group and 100 THAs in a posterolateral approach group were performed at one university hospital by a single, experienced surgeon. These THAs were then followed up for a minimum of 2 years to determine the incidence of postoperative complications. In our study, patients undergoing primary THA by the posterolateral approach were 18.