By: James Pitt  Jun. 20, 2018

Venous thromboembolism (VTE) is a condition in which a blood clot forms in a vein, then may dislodge and block blood supply elsewhere. VTE is a common comorbidity of sepsis. The Surviving Sepsis Campaign recommends that patients with severe sepsis receive daily prophylaxis against VTE, with both pharmacologic therapy and pneumatic compression devices when possible.

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.

By: James Pitt  Jun. 18, 2018

Coronary artery disease (CAD) is the leading cause of death in the US, killing approximately 370,000 people each year. (Coronary heart disease is a synonym). It occurs when plaque builds up in the arteries that feed the heart itself, a condition called coronary atherosclerosis.

By: James Pitt  Jun. 15, 2018

Following Dexur's examination of length of stay (LOS) in sepsis patients in Mississippi, analysts examined how fluid imbalance relates to case mix. CMS divides sepsis patients into three diagnosis-related groups:

• DRG 870 SEPTICEMIA OR SEVERE SEPSIS W MV 96+ HOURS
• DRG 871 SEPTICEMIA OR SEVERE SEPSIS W/O MV 96+ HOURS W MCC

By: James Pitt  Jun. 14, 2018

Anemia is a common complication of chronic kidney disease and renal failure. Gaweda et. al (2014) write that “Anemia in chronic kidney disease (CKD) is primarily a consequence of insufficient erythropoietin (EPO) production.” EPO is a hormone produced primarily in the kidneys, which stimulates red blood cell production in bone marrow. Recombinant human EPO (rHuEPO) can help make up for the lack of EPO production, but rHuEPO alone may not alleviate anemia in all patients, because other components (like iron) are also necessary for normal red blood cell production. According to Nissenson and Strobos (1999), “Deficient available iron is the most common cause of initial poor response to rHuEPO.”

By: James Pitt  Jun. 13, 2018

Coronary artery disease is a condition in which plaque reduces blood flow through arteries to the heart. One of the most common treatments is coronary artery bypass grafting (CABG). This is a surgical procedure in which healthy blood vessels are grafted onto the heart to provide an alternate route for blood to flow, bypassing the occluded arteries.

By: James Pitt  Jun. 12, 2018

Following Dexur’s analysis of length of stay (LOS) in sepsis patients in Mississippi, analysts examined the effects of fluid imbalance on LOS.

By: James Pitt  Jun. 11, 2018

Dexur analysts compared the 20 hospitals with the most CMS inpatient discharges for DRGs 001 and 002 from 2013 to 2016. The national average in-hospital mortality rate for DRG 001 patients was 11.94% from January 2013 to December 2016. St. Luke’s in-hospital mortality rate for these patients was 13% in this period, a 1% difference from national average. The other top 20 hospitals also average slightly higher mortality rates than the national average. The highest was 18% at Stanford Health Care (Stanford, CA), and the lowest 7% at Duke University Health System (Durham, NC).

By: James Pitt  Jun. 08, 2018

Sepsis is a serious condition, in which the immune system mounts a systemic inflammatory response to infection. Controlling fluid balance is an important part of sepsis treatment. Septic shock kills by reducing circulation, and hypovolemia (low fluid) may contribute to worse outcomes, while excess fluid increases the risk of death. Dexur has previously examined fluid balance’s effects on sepsis mortality in California and urosepsis readmissions in Connecticut.

By: James Pitt  Jun. 05, 2018

Venous thromboembolism (VTE) is a condition in which a blood clot breaks loose and travels in the blood, often cutting off circulation in a vessel. Cancer and cancer treatment are risk factors for VTE, and a 2007 paper found VTE occurred in 4.1% of US cancer patients, rising to 5.7% among patients on chemotherapy. VTE risk model calculators such as the International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) take cancer into account. To investigate VTE risk among cancer patients, Dexur analysts examined the incidence of venous thromboembolism in cancer among CMS inpatients discharged at three major New York hospitals from 2013-2016.