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Objective: The objective of this study is to identify variables associated with clinical outcomes after urologic transfers before and during the COVID pandemic. Methods: After IRB approval, a retrospective chart review was performed on adult patients transferred to our institution from 01/01/2018 to 12/31/2019 ("pre‐COVID") and from 01/02/2020 to 12/31/2022 ("COVID"). We identified demographics, origin hospitals, ICD‐10 pre‐ and post‐transfer diagnoses, distance of transfer, and post‐transfer CPT codes. Results: During the study period, our adult urology service accepted 160 transfers with a mean patient age of 71 years. A total of 49/160 (30%) of subjects made up the "pre‐COVID" cohort and 111/160 (70%) made up the "COVID" cohort. There were 11/111 (10%) transfers of >100 miles in the COVID period but 0/49 in the pre‐COVID period (p = 0.02). Patients from the COVID period waited on average 1.2 days longer for a procedure after transfer compared to pre‐COVID period (p = 0.03). The time until a patient's surgical procedure after transfer was a significant predictor of length of stay > 5 days (OR 1.91, CI 1.43 – 2.58, p < 0.01). Different diagnosis upon re‐evaluation after transfer was associated with a decreased rate of subsequent readmission (OR 0.30, CI 0.09–0.97, p = 0.05). Conclusions: Long‐distance transfer, even >100 miles (which we termed "mega‐transfers"), was a new pandemic‐related phenomenon at our institution. Delays in definitive care and changes in diagnoses after transfer were associated with readmission and length of stay. Our findings illustrate the importance of inter‐institutional communication, diagnostic accuracy, and post discharge planning when managing transfer patients. [ABSTRACT FROM AUTHOR]

This paper examines the peer effects in strategic disclosure decisions. We exploit the heterogeneous and intransitive nature of peer networks by mapping out peers using MD&A textual comparability to identify such effects. Using recent developed spatial econometric techniques, we find a strong positive peer effect in the forecast precision decisions, which is consistent with social learning assumption. After mitigating the endogenous problems with two instrumental variables and excluding the geographic factors, our conclusion is still valid. Overall, our result shed light on the role of peer effects in the formation of voluntary disclosure. [ABSTRACT FROM AUTHOR]

Background: Intracerebral hemorrhage (ICH) carries significant morbidity and mortality. Previous single-center retrospective analysis suggests that end-stage renal disease (ESRD) is a risk factor for severe ICH and worse outcomes. This investigation aims to examine the impact of ESRD on ICH severity, complications, and outcomes using a multicenter national database., Methods: The International Classification of Disease, Ninth and Tenth Revision Clinical Modification codes were used to query the National Inpatient Sample for patients with ICH and ESRD between 2010 and 2019. Primary endpoints were the functional outcome, length of stay (LOS), and in-hospital mortality. Multivariate variable regression models and a propensity-score matched analysis were established to analyze patient outcomes associated with baseline patient characteristics., Results: We identified 211,266 patients with ICH, and among them, 7,864 (3.77%) patients had a concurrent diagnosis of ESRD. Patients with ESRD were younger (60.85 vs. 67.64, P < 0.01) and demonstrated increased ICH severity (0.78 vs. 0.77, P < 0.01). ESRD patients experienced higher rates of sepsis (15.9% vs. 6.15%, P < 0.01), acute myocardial infarction (8.05% vs. 3.65%, P < 0.01), and cardiac arrest (5.94% vs. 2.4%, P < 0.01). In addition, ESRD predicted poor discharge disposition (odds ratio [OR]: 2.385, 95% confidence interval [CI]: 2.227-2.555, P < 0.01), longer hospital LOS (OR: 1.629, 95% CI: 1.553-1.709, P < 0.01), and in-hospital mortality (OR: 2.786, 95% CI: 2.647-2.932, P < 0.01)., Conclusions: This study utilizes a multicenter database to analyze the effect of ESRD on ICH outcomes. ESRD is a significant predictor of poor functional outcomes, in-hospital mortality, and prolonged stay in the ICH population., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Brain Circulation.)