Primary sclerosing cholangitis (PSC) is an idiopathic cholestatic liver disease that may lead to biliary strictures and destruction. It is associated with p-ANCA positivity and inflammatory bowel disease, typically ulcerative colitis. The aim of this study is to investigate the trends of inpatient healthcare utilization and mortality from 2008 to 2017 in the United States. The Nationwide Inpatient Sample (NIS) was examined to identify adult patients diagnosed with PSC between 2008 and 2017. Data on patient demographics, resource utilization, mortality, and PSC-related complications were collected. STATA version 16.0 was employed to perform forward stepwise multivariate regression analysis, generating adjusted odds ratios for both primary and secondary outcomes. Primary outcomes included the inpatient mortality rate and healthcare resource utilization (length of stay, total charges, and trends over the study period). Secondary outcomes focused on trends in associated comorbidities and malignancies in patients with PSC. The average total charge increased by 32.2% ± 2.12 from USD 61,873 ± 2567 in 2008 to USD 91,262 ± 2961 in 2017. Concurrently, the average length of stay declined from 8.07 ± 0.18 days in 2008 to 7.27 ± 0.13 days in 2017. The APR-DRG severity of illness and risk of death significantly increased (major or extreme) during the study period (2008 to 2017), with severity rising from 73.6% to 82.7% (coefficient: 0.21, 95% CI: 0.13-0.28) and risk of death from 45.3% to 60.9% (coefficient: 0.15, 95% CI: 0.08-0.23). The proportion of patients with HCC increased from 1.3% to 7.9% (coefficient: 2.13, 95% CI: 1.9-2.8). Conversely, the percentage of patients with cholangiocarcinoma (CCA) decreased from 5.1% to 2.8% (coefficient: -0.36, 95% CI: -0.25 to -0.46). There was rising mortality and healthcare resource utilization among patients with PSC from the years 2008 to 2017. These trends were paralleled by increasing rates of decompensated cirrhosis, HCC, and liver transplants. However, the incidence of CCA decreased during this time period. African American patients with PSC had worse inpatient mortality outcomes and healthcare utilization as compared to white patients. Further studies are warranted to investigate a possible causal link amongst these trends.
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http://dx.doi.org/10.3390/diagnostics14222493 | DOI Listing |
Background: Flavonoids are believed to have potential anti-aging effects due to their anti-inflammatory and antioxidant properties. However, the effectiveness of dietary flavonoids and their subclasses in delaying aging has yet to be confirmed. Our study intends to examine relationship between them.
View Article and Find Full Text PDFDisabil Health J
December 2024
Center for Health Promotion and Health Equity, Brown University School of Public Health, 121 S Main St, Providence, RI, 02903, USA; Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 S Main St, Providence, RI, 02903, USA; Department of Epidemiology, Brown University School of Public Health, 121 S Main St, Providence, RI, 02903, USA. Electronic address:
Background: Transgender and gender diverse (TGD) adults experience disability at twice the rate of cisgender (non-TGD) adults in the US. TGD people of color and low-income TGD people experience intersecting discrimination that may compound chronic conditions and disability. To our knowledge, no research has focused on chronic conditions among TGD Medicare beneficiaries with disabilities.
View Article and Find Full Text PDFNeurol Ther
December 2024
Columbia University, 630 W 168Th St (P&S Unit 16), New York, NY, 10032, USA.
Introduction: The availability of anti-amyloid therapy for mild cognitive impairment (MCI) due to Alzheimer's disease and mild Alzheimer's dementia (AD) has underscored the need for realistic estimates of the population with AD/MCI within the healthcare system to assure adequate preparedness. We hypothesize that administrative databases can provide real-world epidemiologic estimates reflecting the population with diagnosed (known) MCI and AD. This study was conducted to estimate diagnostic incidence and prevalence of AD and all-cause MCI among the Medicare fee-for-service (FFS) and Medicare Advantage (MA) beneficiaries in the United States.
View Article and Find Full Text PDFFront Sociol
December 2024
Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain.
Lone mothers have been found to report lower average mental health than partnered mothers. Following the 'stress process model', disparities in women's mental health by family structure could be explained by lone mothers' higher exposure to multiple forms of stressors, compared to partnered mothers. Yet, this hypothesis has not been tested in previous studies.
View Article and Find Full Text PDFJ Diabetes Metab Disord
June 2025
Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Objectives: This cohort study investigated the possible association of dietary nitrate (NO)/nitrite (NO) intake and risk of progression to type 2 diabetes (T2D) across different phenotypes of prediabetes (Pre-DM).
Methods: A total of 1586 adults diagnosed with Pre-DM [i.e.
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