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Racial and gender-based disparities and trends in common psychiatric conditions in liver cirrhosis hospitalizations:A ten-year United States study

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World Journal of Hepatology 2023年第2期15卷 289-302页

作者： Pratik Patel Hassam Ali Faisal Inayat rahul pamarthy Alexa Giammarino Fariha Ilyas Lucia Angela Smith-Martinez Sanjaya K Satapathy Department of Gastroenterology Mather Hospital and Hofstra University Zucker School of MedicinePort JeffersonNY 11777United States Department of Internal Medicine East Carolina University Brody School of MedicineGreenvilleNC 27834United States Department of Internal Medicine Allama Iqbal Medical CollegeLahore 54550PunjabPakistan Department of Internal Medicine North Shore University Hospital and Hofstra University Zucker School of MedicinePort JeffersonNY 11777United States Department of Psychiatry East Carolina University Brody School of MedicineGreenvilleNC 27834United States Department of Hepatology North Shore University Hospital and Hofstra University Zucker School of MedicineManhassetNY 11030United States

BACKGROUND Chronic liver disease is associated with various neuropsychiatric *** are currently no large studies assessing and comparing the prevalence of psy-chiatric illnesses based on patient profiles and the etiology of *** To examine the trends of hospitalizations among psychiatric conditions in *** We used the National Inpatient Sample database 2016-2019 for the primary diagnosis of liver *** outcomes included the prevalence,trends,and associations of psychiatric diagnoses in these ***-square for categorical variables and the Wilcoxon rank test for continuous variables were *** The prevalence of generalized anxiety disorder(GAD)in liver cirrhosis hospitalizations increased from 0.17%in 2009 to 0.92%in 2019(P<0.001).The prevalence of depression increased from 7%in 2009 to 12%in 2019(P<0.001).Attention deficit hyperactivity disorder(ADHD)prevalence increased from 0.06%to 0.24%.The prevalence of schizophrenia increased from 0.59%to 0.87%(P<0.001).Schizoaffective disorder prevalence increased from 0.10%to 0.35%(P<0.001).Posttraumatic stress disorder(PTSD)prevalence displayed increasing trends from 0.36%in 2009 to 0.93%in 2019(P<0.001).The prevalence of suicidal ideation increased from 0.23%to 0.56%in *** related to alcoholic liver disease[adjusted odds ratios(aOR)1.18,95%CI 1.08-1.29,P<0.001]and non-alcoholic fatty liver disease(NAFLD)(aOR 1.14,95%CI 1.01-1.28,P=0.025)was associated with depression more than other ***-and NAFLD-associated cirrhosis had a stronger link to psychiatric *** had a higher association with GAD(aOR 2.56,95%CI 2.14-3.06,P<0.001),depression(aOR 1.78,95%CI 1.71-1.84,P<0.001),bipolar disorder(aOR 1.64,95%CI 1.52-1.77,P<0.001]and chronic fatigue(aOR 2.31,95%CI 1.31-4.07,P<0.001)when compared to ***,Hispanics,and Asian/Native Americans had a significantly lower association with GAD,depression,bipolar disorder,PTSD,and ADHD wh

关键词： Liver cirrhosis hospitalizations Psychiatric conditions Racial and gender disparities

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Acute venous thromboembolism in acute pancreatitis based on the severity:a retrospective cohort study

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Journal of Pancreatology 2022年第1期5卷 10-17页

作者： Hassam Ali Swethaa Manickam rahul pamarthy Muhamad Fahd Farooq William Leland Department of Internal Medicine East Carolina University/Vidant Medical CenterGreenvilleNC Department of Gastroenterology East Carolina University/Vidant Medical CenterGreenvilleNCUSA

Objective: Acute pancreatitis (AP) results in systemic inflammatory responses and activates coagulation pathways. We intend to investigate the risk and hospital outcomes of acute venous thromboembolisms (VTE) in patients with ***: We retrospectively analyzed patients with AP from 2016 to 2019 using the National Inpatient Sample database. Primary outcome was the effect of VTE on the length of stay, inpatient costs, and mortality. Hierarchical multivariate logistic regression models were built using univariate ***: The study included 909,354 weighted discharges with AP. 2.1% of cases had an acute VTE. The length of stay was 5.9 days longer in the hospital of AP patients with VTE compared to AP with no VTE (P <.001). Total hospital charge per patient was $71,914 in patients with VTE compared to AP with no VTE (P < .001). Mortality was higher in AP patients with VTE compared to AP with no VTE (adjusted odds ratio [AOR] 4.2, 95% confidence interval [CI]: 3.4-5.3,P <.001). AP was associated with an increased VTE risk during inpatient stay (AOR 1.06, 95% CI 1.04-1.1,P <.001) There was an increased association of lower and upper extremity deep venous thrombosis with AP without necrosis (AOR 6.9, 95% CI 6.4-7.4,P <.001) and AP with infected necrosis (AOR 12.2, 95% CI 10.6-14.1,P <.001) but not in AP without necrosis (AOR 0.77, 95% CI 0.74-0.81,P <.001).Conclusion: VTE in AP increases length of stay and inpatient costs. The prognosis is poor in such patients, with increased inpatient mortality compared to no VTE. AP with necrosis can increase chances of all VTE subtypes;however, AP without necrosis does not increase upper and lower extremity VTE risk.

关键词： Acute pancreatitis Deep venous thrombosis Necrosis Severity Venous thromboembolism

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