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Readmission rates and outcomes in adults with and without COVID-19 following inpatient chemotherapy admission:A nationwide analysis

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World Journal of Clinical Oncology 2023年第8期14卷 311-323页

作者： Philip Kanemo Keffi Mubarak Musa Vaishali Deenadayalan Rafaella Litvin Olubunmi Emmanuel Odeyemi Abdultawab shaka Naveen Baskaran hafeez shaka Department of Internal Medicine Rapides Regional Medical CenterAlexandriaLA 71301United States Department of Medicine Ahmadu Bello University Teaching HospitalZaria 88445KadunaNigeria Department of Internal Medicine John H.StrogerJr.Hospital of Cook CountyChicagoIL 60623United States Department of Internal Medicine Ladoke Akintola University Teaching HospitalOgbomoso 210101OyoNigeria Department of Medicine Windsor University School of MedicineSt.KittsFrankfortIL 60423United States Department of Medicine University of FloridaGainesvilleFL 32610United States

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has received considerable attention in the scientific community due to its impact on healthcare systems and various ***,little focus has been given to its effect on cancer *** To determine the effect of COVID-19 pandemic on cancer patients’*** A retrospective review of a Nationwide Readmission Database(NRD)was conducted to analyze hospitalization patterns of patients receiving inpatient chemotherapy(IPCT)during the COVID-19 pandemic in *** cohorts were defined based on readmission within 30 d and 90 *** information,readmission rates,hospital-specific variables,length of hospital stay(LOS),and treatment costs were *** were assessed using the Elixhauser comorbidity *** Cox regression analysis was performed to identify independent predictors of *** analysis was conducted using Stata■Version 16 *** the NRD data is anonymous and cannot be used to identify patients,institutional review board approval was not required for this *** A total of 87755 hospitalizations for IPCT were identified during the *** the 30-day index admission cohort,55005 patients were included,with 32903 readmissions observed,resulting in a readmission rate of 59.8%.For the 90-day index admission cohort,33142 patients were included,with 24503 readmissions observed,leading to a readmission rate of 73.93%.The most common causes of readmission included encounters with chemotherapy(66.7%),neutropenia(4.36%),and sepsis(3.3%).Comorbidities were significantly higher among readmitted hospitalizations compared to index hospitalizations in both readmission *** total cost of readmission for both cohorts amounted to 1193000000.00 *** predictors of 30-day readmission included peripheral vascular disorders[Hazard ratio(HR)=1.09,P<0.05],paralysis(HR=1.26,P<0.001),and human immunodeficiency virus/acquired immuno-de

关键词： Chemotherapy Coronavirus disease 2019 pandemic Nationwide readmission database Readmission rates Cancer Healthcare cost

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Trends of alcoholic liver cirrhosis readmissions from 2010 to 2018:Rates and healthcare burden associated with readmissions

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World Journal of Hepatology 2021年第12期13卷 2128-2136页

作者： Asim Kichloo Zain El-Amir Dushyant Singh Dahiya Farah Wani Jagmeet Singh Dhanshree Solanki Ehizogie Edigin Precious Eseaton Asad Mehboob hafeez shaka Department of Internal Medicine Central Michigan University College of MedicineSaginawMI 48602United States Department of Internal Medicine Samaritan Medical CenterWatertownNY 13601United States Department of Internal Medicine Guthrie Robert Packer HospitalSayrePA 18840United States Department of Internal Medicine Rutgers UniversityNew BrunswickNJ 07103United States Department of Internal Medicine John H Stroger Hospital of Cook CountyChicagoIL 60612United States Department of Internal Medicine University of Benin School of MedicineEdo 300213Nigeria Division of Gastroenterology Department of Internal MedicineCovenant HealthcareSaginawMI 48602United States

BACKGROUND Alcoholic liver cirrhosis(ALC)is a chronic liver disease with varying disease *** of ALC are associated with poor *** To identify and assess trends of readmissions for ALC over an eight-year *** This retrospective interrupted trend study analysed 30-d readmissions of ALC in the United States from 2010 to 2018 using the National Readmissions *** for ALC was the reason for index admission obtained using the International Classification of Diseases codes(571.2 and K70.3X).Biodemographic characteristics and hospitalization trends were highlighted over time.A multivariate regression analysis model was used to calculate the trend for riskadjusted odds of 30-d all-cause ALC readmissions,ALC specific readmission rate,ALC readmission proportion,inpatient mortality,mean length of stay(LOS)and mean total hospital cost(THC)following adjustments for age,gender,grouped Charlson Comorbidity Index,insurance,mean household income,and hospital *** There was a trend towards increasing total 30-d readmissions of ALC from 7660 in 2010 to 15085 in 2018(P<0.001).Patients readmitted for ALC were noted to have an increasing comorbidity burden over *** noted a rise in the risk-adjusted 30-d all-cause readmission of ALC from 24.9%in 2010 to 29.9%in 2018(P<0.001).ALC-specific readmission rate increased from 6.3%in 2010 to 8.4%in 2018(P<0.001)while ALC readmission proportion increased from 31.4%in 2010 to 36.3%in 2018(P<0.001).Inpatient mortality for 30-d readmissions of ALC declined from 10.5%in 2010 to 8.2%in 2018(P=0.0079).However,there was a trend towards increasing LOS from 5.6 d in 2010 to 6.3 d in 2018(P<0.001)and increasing THC from 13790 dollars in 2010 to 17150 dollars in 2018(P<0.001).The total days of hospital stay attributable to 30-d readmissions of ALC increased by 119.2%while the total attributable hospital costs increased by 149%by the end of *** There was an increase in th

关键词： Alcoholic liver cirrhosis Readmissions Epidemiology Trends Mortality

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Systemic adverse effects and toxicities associated with immunotherapy:A review

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World Journal of Clinical Oncology 2021年第3期12卷 150-163页

作者： Asim Kichloo Michael Albosta Dushyant Dahiya Jean Claude Guidi Michael Aljadah Jagmeet Singh hafeez shaka Farah Wani Akshay Kumar Manidhar Lekkala Department of Internal Medicine Central Michigan UniversitySaginawMI 48603United States Department of Internal Medicine Samaritan Medical CenterWatertownNY 13601United States Department of Internal Medicine Medical College of WisconsinMilwaukeeWI 53201United States Department of Nephrology Guthrie Robert Packer HospitalSayrePA 18840United States Department of Internal Medicine John H Stroger Jr.Hospital of Cook CountyChicagoIL 60612United States Department of Family Medicine Samaritan Medical CenterWatertownNY 13601United States Department of Surgery University of PittsburghPittsburghPA 15213United States Department of Hematology and Oncology University of Rochester Medical CenterRochesterNY 14642United States

Immunotherapy is rapidly evolving secondary to the advent of newer immunotherapeutic agents and increasing approval of the current agents by the United States Food and Drug Administration to treat a wide spectrum of *** agents have gained immense popularity due to their tumorspecific *** is slowly transforming into a separate therapeutic entity,and the fifth pillar of management for cancers alongside surgery,radiotherapy,chemotherapy,and targeted ***,like any therapeutic entity it has its own adverse *** the increasing use of immunotherapeutic agents,it is vital for physicians to acquaint themselves with these adverse *** aim of this review is to investigate the common systemic adverse effects and toxicities associated with the use of different classes of immunotherapeutic *** provide an overview of potential adverse effects and toxicities associated with different classes of immunotherapeutic agents organized by organ systems,as well as an extensive discussion of the current recommendations for treatment and clinical trial *** we continue to see increasing usage of these agents in clinical practice,it is vital for physicians to familiarize themselves with these effects.

关键词： Immunotherapy Cancer Malignancy Adverse effects Immune checkpoint inhibitor Monoclonal antibody

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Increasing thirty-day readmissions of Crohn’s disease and ulcerative colitis in the United States:A national dilemma

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World Journal of Gastrointestinal Pathophysiology 2022年第3期13卷 85-95页

作者： Dushyant Singh Dahiya Abhilash Perisetti Asim Kichloo Amandeep Singh Hemant Goyal Laura Rotundo Madhu Vennikandam hafeez shaka Gurdeep Singh Jagmeet Singh Sailaja Pisipati Mohammad Al-Haddad Madhusudhan R Sanaka Sumant Inamdar Department of Internal Medicine Central Michigan University College of MedicineSaginawMI 48601United States Division of Gastroenterology Parkview Cancer InstituteFort WayneIN 46845United States Division of Gastroenterology and Hepatology Cleveland Clinic FoundationClevelandOH 44195United States Department of Internal Medicine The Wright Center for Graduate Medical EducationScrantonPA 18505United States Department of Internal Medicine Mercer University School of MedicineMaconGA 31207United States Department of Gastroenterology and Hepatology Sparrow Hospital/Michigan State University College of Human MedicineLansingMI 48912United States Department of Internal Medicine John H.StrogerJr.Hospital of Cook CountyChicagoIL 60612United States Department of Internal Medicine Our Lady of Lourdes Memorial HospitalBinghamtonNY 13905United States Department of Internal Medicine Guthrie Robert Packer HospitalSayrePA 18840United States Division of Gastroenterology and Hepatology Mayo ClinicScottsdaleAZ 85259United States Division of Gastroenterology and Hepatology Indiana University School of MedicineIndianapolisIN 46202United States Division of Gastroenterology and Hepatology University of Arkansas for Medical SciencesLittle RockAR 72205United States

BACKGROUND The prevalence of Crohn’s disease(CD)and ulcerative colitis(UC)is on the rise *** rising prevalence is concerning as patients with CD and UC may frequently relapse leading to recurrent hospitalizations and increased healthcare *** To identify trends and adverse outcomes for 30 d readmissions for CD and *** This was a retrospective,interrupted trends study involving all adult(≥18 years)30 d readmissions of CD and UC from the National Readmission Database(NRD)between 2008 and ***<18 years,elective,and traumatic hospitalizations were excluded from this *** identified hospitalization characteristics and readmission rates for each calendar *** of inpatient mortality,mean length of hospital stay(LOS)and mean total hospital cost(THC)were calculated using a multivariate logistic trend analysis adjusting for age,gender,insurance status,comorbidity burden and hospital ***,trends between CD and UC readmissions were compared using regression of the interaction coefficient after adjusting for age and gender to determine relative trends between the two ***®Version 16 software(StataCorp,TX,United States)was used for statistical analysis and P value≤0.05 were considered statistically *** Total number of 30 d readmissions increased from 6202 in 2010 to 7672 in 2018 for CD and from 3272 in 2010 to 4234 in 2018 for *** noted increasing trends for 30-day all-cause readmission rate of CD from 14.9%in 2010 to 17.6%in 2018(P-trend<0.001),CD specific readmission rate from 7.1%in 2010 to 8.2%in 2018(P-trend<0.001),30-day all-cause readmission rate of UC from 14.1%in 2010 to 15.7%in 2018(P-trend=0.003),and UC specific readmission rate from 5.2%in 2010 to 5.6%in 2018(P-trend=0.029).There was no change in the risk adjusted trends of inpatient mortality and mean LOS for CD and UC ***,we found an increasing trend of mean THC for UC *** comparison,there w

关键词： Inflammatory bowel disease Crohn’s disease Ulcerative colitis Readmissions Trends

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