Changes in Mortality and Length of Stay for Aspergillosis-Related Hospitalizations in the United States from 2001 to 2011.
Mizusawa, Masako.
2016
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Abstract: [Importance] Aspergillosis is a life-threatening infection associated with significant morbidity and mortality. In the last 15 years there have been major changes in the clinical management of aspergillosis. Most epidemiological studies of the burden of aspergillosis to date have been based on data from single centers or multicenter registries of invasive aspergillosis or transplant-asso... read moreciated infections. [Objective] To evaluate changes in mortality and length of stay in aspergillosis-related hospitalizations in the United States from 2001 to 2011 using a national inpatient administrative database. [Design, Setting, and Participants] Using the 2001, 2006 and 2011 Nationwide Inpatient Sample, we analyzed changes in in-hospital mortality and length of stay over time using 16,323 adult hospitalizations with aspergillosis (ICD-9 117.3) or pulmonary aspergillosis (ICD-9 484.6) as a primary or secondary diagnosis. [Main Outcomes and Measures] Change in in-hospital mortality and length of stay over time with adjustment for age, sex, renal failure and traditional and non-traditional risk factors for aspergillosis. [Results] From 2001 to 2011 there was 50% increase in the absolute number of the aspergillosis-related hospitalizations as well as in the annual rate of aspergillosis cases per 100,000 hospitalizations. The crude in-hospital mortality rate for aspergillosis-related hospitalizations was 18.7% in 2001, 11.7% in 2006 (43% relative odds reduction), and 7.8% in 2011 (63% relative odds reduction since 2001, p for trend < 0.0001). The risk of spending one additional day in the hospital was also reduced by 7% in 2006, and by 15% in 2011 compared to 2001 (p for trend < 0.0001). These significant reductions in in-hospital mortality and length of stay persisted after multivariable adjustment for demographic and clinical factors. Significant time trends in reduced in-hospital mortality and length of stay were also observed when limited to the subgroup of aspergillosis-related hospitalizations with any of the traditional risk factors for aspergillosis. [Conclusions and Relevance] In the United States, mortality and length of stay for aspergillosis-related hospitalizations have significantly decreased from 2001 to 2011 while the number of these hospitalizations have increased over time.
Thesis (M.S.)--Tufts University, 2016.
Submitted to the Dept. of Clinical & Translational Science.
Advisors: David Snydman, and Jessica Paulus.
Committee: Lori Lyn Price, Helen Boucher, and Jennifer Chow.
Keyword: Epidemiology.read less - ID:
- dn39xd48k
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