Disease Burden News, Research & Data Analysis

In-Hospital Quality Outcomes for Hepatocellular Carcinoma with Gastrointestinal Hemorrhage

In Hepatocellular Carcinoma (HCC)

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By: James Pitt  Dec. 19, 2018

Gastrointestinal hemorrhage contributed to 3% of hospitalizations and 2.35% of in-hospital deaths among patients with hepatocellular carcinoma as a primary or secondary diagnosis, according to a Dexur analysis of 2013-2017 Medicare claims data.

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Doppler Ultrasound Devices Like Deltex CardioQ Could Help Address Excess Length of Stay in Bowel Surgery Patients With Major Complications

In Fluid Imbalance

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By: James Pitt  Oct. 22, 2018

In goal-directed fluid therapy (GDT or GDFT), physicians use hemodynamic variables such as stroke volume (the amount of fluid the heart moves with each beat) to estimate the amount of fluid in circulation. Physicians provide fluid as needed to keep these hemodynamics variables near target values.

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Mortality Rates in Aortic Valve Replacement: Are Rapid-Deployment Valves like LivaNova Perceval Cost-Effective?

In Heart Failure

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By: James Pitt  Oct. 15, 2018

Heart valve replacement is a competitive field, with many competing options. A recently developed category is rapid deployment valves, which do not require suturing. This allows for much faster implantation. Payors class these valves as experimental, under ICD-10 procedure codes like X2RF032 for open-approach implantation, rather than under the ICD-10 codes like 02RF08Z that conventional heart valves are assigned.

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Catheter Ablation Could Potentially Save $1,725 Per Hospitalization in Paroxysmal AFib Without Complications

In Atrial fibrillation (AFib)

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By: James Pitt  Oct. 08, 2018

Atrial fibrillation, the most common arrhythmia, is a condition in which the heart's upper chambers contract rapidly and irregularly. Twenty years ago, Haïssaguerre et. al discovered that pulmonary veins can spontaneously trigger AFib, and isolating pulmonary veins from each other with radiofrequency catheter ablation can correct it.

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How to Evaluate the Impact of Venous Thromboembolism (VTE): Part 2: Incidence

In Venous Thromboembolism (VTE)

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By: James Pitt  Aug. 13, 2018

Hospitalized patients are at greater risk of venous thromboembolism than the general population, in part because immobility increases VTE risk. According to the CDC report on healthcare-associated VTE, up to 70% of HA-VTE cases are preventable.

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Septic Shock Accounts for Large Share of In-Hospital Mortality for Infectious Disease and Respiratory Patients at Top Michigan Hospitals

In Sepsis

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By: James Pitt  Aug. 06, 2018

Severe sepsis kills 15 to 30% of the million Americans affected per year, according to NIH estimates. Septic shock accounts for a large share of those deaths.

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Chicago’s Wide Variance in Fracture Readmission Rates Indicates Opportunities for Osteoporosis Treatment

In Osteoporosis

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By: James Pitt  Jul. 30, 2018

Osteoporosis is a common disease of aging, associated with weakened bones. Bone fractures are associated with higher subsequent mortality. According to University of Washington Medicine, “The one-year mortality following a hip fracture is 12 to 24%. It is estimated that 14% of deaths following a hip or pelvic fracture in previously ambulatory women were caused or hastened by the fracture.”

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Pressure Ulcer Readmission Rates in Los Angeles Area Hospitals Range From 0.94% to 3.83%

In Pressure Ulcer

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By: James Pitt  Jul. 20, 2018

Pressure ulcers are wounds that develop due to reduced blood flow, typically in patients who lie in the same position for long periods. Elderly and critically ill patients are at particular risk. A study based on 2006-2007 Medicare data found that patients with pressure ulcers are more likely to die in-hospital (odds ratio 2.81); have more than double the average length of stay; and are more likely to be readmitted within 30 days of discharge (odds ratio 1.33).

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In Arizona, Asthma Highest in Tucson and Phoenix, COPD Highest Near State Borders

In Chronic Obstructive Pulmonary Disease (COPD)

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By: James Pitt  Jul. 19, 2018

Asthma and chronic obstructive pulmonary disease (COPD) are two of the most common lung disorders in the United States. Differential diagnosis can be a challenge. According to the American Academy of Family Physicians guidelines on distinguishing asthma from COPD, asthma generally has earlier onset, more variable symptoms, and normal chest X-ray. Many options for diagnosis and treatment are available, including recently developed digital health tools.

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Bon Secours Hospital Treats the Most Surgical Patients with Iron Deficiency Anemia in Maryland

In Iron Deficiency Anemia (IDA)

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By: James Pitt  Jul. 04, 2018

Iron deficiency anemia (IDA) is a condition in which the body has too little iron to properly supply red blood cells, leading to fatigue and weakness. According to the Merck Manual, blood loss is the most common cause of IDA. About 70% of the body's iron is already in red blood cells, rather than stored in reserve, so patients may require iron supplementation after major blood loss.

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Mortality Rates Nearly Double with Hyperkalemia in California DRG 871 Sepsis Patients

In Hyperkalemia

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By: James Pitt  Jul. 03, 2018

Hyperkalemia, i.e. high potassium, is a common electrolyte imbalance. Like other forms of fluid imbalance, it may affect sepsis outcomes. Dexur has extensively reported on fluid imbalance in sepsis.

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In Southern Arizona Hospitals, DRG 640 Hyponatremia Rate Exceeds National Rate at All But One

In Hyponatremia

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By: James Pitt  Jun. 27, 2018

Hyponatremia, i.e. low blood sodium, is a common electrolyte imbalance. According to the Mayo Clinic, risk factors for hyponatremia include age, certain medications, kidney disease and heart failure (due to their effects on water excretion), and intensive physical activities like marathons.

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Jackson Health Hospitals Have Lower ABSSSI Incidence Than Miami-Dade County Average

In Acute Bacterial Skin and Skin Structure Infections (ABSSSI)

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By: James Pitt  Jun. 26, 2018

A June 4 Miami Herald investigation found that according to CMS data, Jackson Health System performed under the national benchmark on incidence of MRSA bloodstream infections, but at or above the national benchmark on five other types of infection. Dr. Lilian Abbo of Jackson Health attributed this to the case mix at Jackson Health and the high prevalence of MRSA in Miami-Dade County.

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Asthma is a Significant Contributor to 30 Day Readmissions in Mississippi

In Asthma

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By: James Pitt  Jun. 19, 2018

Asthma is a chronic lung disease which narrows the airways. It affects over 25 million people in the US, including 7 million children. Risk factors for developing asthma include air pollution, poverty, and tobacco smoke. Though asthma is often regarded as a childhood disease, 8.8% of adults had asthma as of 2011-2014.

Dexur analysts examined hospital-level data at the twenty hospitals in Mississippi with the most Medicare-eligible inpatient discharges for asthma in 2013-2016. The average readmission rate across these hospitals was close to Mississippi's state average, so they are a fair representation of the state.

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Florida Orlando Hospital Has Particularly Low Mortality, Length of Stay, & Readmission Rates for Interstitial Lung Disease With Major Complications

In Interstitial Lung Disease (ILD)

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By: James Pitt  May. 30, 2018

Interstitial lung diseases (ILD) are more than 300 different conditions with similar symptoms. According to the European Respiratory Society, “Only about one in three cases of interstitial lung disease has a known cause.” Different ILDs present very different risks: “Survival rates at 5 years range from 20% for idiopathic pulmonary fibrosis [IPF] to almost 100% for cryptogenic organizing pneumonia.”

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High Variation in Readmissions May Suggest Need For Better Lung Cancer Diagnostics in New York

In Lung Cancer

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By: James Pitt  May. 29, 2018

Lung cancer rates are falling, but it remains the leading cause of cancer deaths in the US. Detecting cancer early can improve survival. But in recent years, overdiagnosis became a concern. The only lung cancer screen the CDC recommends is low dose CT (LDCT). But even LDCT picks up many findings that may not be dangerous. A 2016 randomized clinical trial in The Lancet Oncology found that only 4% of new solid nodules detected on LDCT were lung cancer.

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Cigarette Use Data May Help Pinpoint Patients At Particular Risk of Malignant Hypertension in Kentucky; Louisville at Low Risk

In Hypertension

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By: James Pitt  May. 28, 2018

People in industrialized countries have an over 90% lifetime risk of developing hypertension, according to a 2007 review in The Lancet. Many diseases cause hypertension. Primary or “essential” hypertension is defined as hypertension with no such cause. This definition is misleading because diet, exercise, and several known genes affect the risk of primary hypertension.

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