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This study aims to determine the most common reasons for emergency department (ED) visits of pediatric patients with major depressive disorder (MDD). We abstracted data from the Nationwide Emergency Department Sample. A total of 380,095 ED visits for patients aged

Introduction: Since the 1999 Institute of Medicine report, hospitals have implemented a myriad of measures to protect patients from medical errors. At this point, looking beyond errors may bring additional safety benefits. This study aims to analyze predictors of in-hospital death regardless of underlying diagnoses in an effort to identify additional targets for improvement. Methods: We performed a retrospective study of hospitalizations from the 2016-2019 National Inpatient Sample (NIS) database. Logistic regression analyses were used to calculate adjusted odds ratios (OR) for variables associated with in-hospital death. Results: There were 121,026,484 adult hospital discharges in the database. Multivariable analysis showed the following variables were associated with higher in-hospital death: Age (OR, 1.04), Charlson Comorbidity Index (OR, 1.23), male (OR, 1.16), income Q1 (OR, 1.12), income Q2 (OR, 1.07), west region (OR, 1.07), non-elective admission (OR, 2.01), urban hospital location (OR, 1.17), and weekend admission (OR, 1.14). Percentage of deaths for weekend versus weekday admissions was 2.7% versus 2.1%. Fewer procedures (ICD-10-PCS) were done in first 24 hours of weekend admissions when compared to weekday admissions (34.8% vs 46.8%; p

Hyperthyroidism is associated with an elevated risk of cardiovascular events and worse hospital outcomes. The Nationwide Readmissions Database (NRD) 2018 was used to determine the characteristics of 30-day readmission in patients with hyperthyroidism. The 30-day all-cause readmission rate for hyperthyroidism was 10.3%. About 21.7% had hyperthyroidism as the principal diagnosis on readmission. Readmissions were associated with an increased odds of inpatient mortality (odds ratio, 7.04; 95% confidence interval [CI], 3.97 to 12.49), length of stay (5.2 days vs. 4.0 days; 95% CI, 0.7 to 1.8), total hospital charges, and cost of hospitalizations. Independent predictors of 30-day all-cause readmissions included Charlson Comorbidity Index ≥3 (adjusted hazard ratio [aHR], 1.76; 95% CI, 1.15 to 2.71), discharge against medical advice (aHR, 2.30; 95% CI, 1.50 to 3.53), protein-energy malnutrition (aHR, 1.54; 95% CI, 1.15 to 2.07), and atrial fibrillation (aHR, 1.41; 95% CI, 1.11 to 1.79). Aggressive but appropriate monitoring is warranted in patients with hyperthyroidism to prevent readmissions.

This article explores the relationship between hidradenitis suppurativa (HS), systemic inflammatory response syndrome (SIRS), and sepsis. It analyzes data from the National Inpatient Sample (NIS) to compare outcomes of patients with HS and sepsis to those without HS. The study finds that patients with HS who were hospitalized with sepsis had lower mortality rates and shorter hospital stays compared to patients without HS. The most common cause of hospitalization and in-hospital deaths in both groups was sepsis from an unspecified organism. The article also includes a sensitivity analysis that suggests sepsis in HS may be overdiagnosed and discusses the limitations of the NIS database. It suggests that patients with HS without other clinical causes for sepsis should be considered to have systemic inflammatory response syndrome caused by HS exacerbation itself. [Extracted from the article]

The length of hospital stay and 30-day all-cause readmission rate are key hospital performance metrics in acute heart failure (AHF) care. While a tremendous amount of resources is being dedicated to improving both metrics, the impact AHF related hospital length of stay on the 30-day all-cause readmission rate remains unstudied in the United States population. OBJECTIVE: The primary objective of the study was to evaluate the impact of hospital length of stay (LOS) for acute heart failure (AHF) related admissions on the 30-day all-cause readmission rate. A retrospective study was performed using the Agency for Healthcare Research and Quality's Healthcare Cost and Utilization Project Nationwide Readmission Database for the year 2018. We collected data on hospital readmissions for adults who were hospitalized for AHF and discharged. The primary outcome was the impact of AHF length of hospital stay on the 30-days all-cause readmission rates. Secondary outcomes were independent predictors of 30-day all-cause readmission, and resource use (total hospitalization costs). LOS was subdivided into LOS1(1-2 days), LOS2(3-5 days), and LOS3 (6 days and above), and the readmission rates were determined for each subgroup. Univariate and multivariate regression analysis using the Cox proportional hazard model was used to evaluate the impact of LOS on the 30-day all-cause readmission rate and to identify independent predictors for 30-day all-cause readmission. A cohort of 98,502 index AHF admissions were identified with 45.8% females and mean age of 69.3 years. The average LOS in the index AHF admission cohort was 5.57 days with a 30-day all-cause readmission rate of 16.7%. A total of 94,942 hospital days were associated with readmission, and the total health care in-hospital economic burden was $1.3 billion (in charges). There were 24632, 41874, 31996 admissions in the LOS1, LOS2 and LOS3 subcategories respectively. On multivariate analysis, the LOS subcategory did not significantly impact the 30-day all-cause readmission rates in the index AHF related hospital admission (LOS1; hazard ratio[HR]: 0.952; 95% confidence interval[CI]: 0.88 - 1.20; p=0.211, LOS 2; HR: 0.947; CI: 0.89 - 1.01; p=0.08, LOS 3; HR: 1.06; CI: 0.99 - 1.12; p=0.08]. The independent predictors for readmission identified were aortic stenosis (HR: 1.25; CI: 1.14- 1.37; P= < 0.0001), chronic obstructive pulmonary disease (COPD) (HR: 1.14; CI: 1.07- 1.20; P= < 0.0001), baseline chronic kidney disease (CKD)(HR: 1.14; CI: 1.06- 1.24; p=0.001), and leaving the hospital against medical advice (AMA) (HR: 2.09; CI- 1.83- 2.39; p = < 0.0001). The LOS for AHF-related admission did not significantly impact the 30-day all-cause readmission rates. The independent predictors of the 30-day all-cause readmission rate were leaving AMA, baseline COPD, CKD, and aortic stenosis. [ABSTRACT FROM AUTHOR]