national inpatient sample pubmed

Fischer A, Zimovetz E, Ling C, Esser D, Schoof N. Autoimmun Rev. This study evaluates contemporary national trends in red blood cell (RBC), plasma, platelet, and cryoprecipitate transfusions. This study shows that two databases commonly used in orthopaedic research can identify similar populations of operative patients but may generate very different results for specific commonly studied comorbidities and adverse events. The percentage of hospitalizations with an RBC transfusion decreased from 4.22% (2015Q4) to 3.79% (2018Q4) (QPC = 0.72; 95% confidence interval [CI], 1.26 to 0.19; Ptrend = .008). The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The mean age was 80.8 years (standard error of the mean: 0.1). Unweighted, it contains data from more than 7 million hospital stays each year. HHS Vulnerability Disclosure, Help Please enable it to take advantage of the complete set of features! Before This site needs JavaScript to work properly. HCUP, the NIS, and other supporting tools must be correctly cited in the abstract and manuscript. Hospitals are stratified by location, teaching status, bed size, ownership/control, and US census divisions. J Ment Health Policy Econ. MeSH Teng TL, Menendez ME, Okike K, Cassidy C, Salzler M. Clin Orthop Relat Res. The National Inpatient Sample: A Primer for Neurosurgical Big Data Research and Systematic Review. Bookshelf Main outcomes and measures: The full-text version of this article contains a data supplement. Wallace ZS, Lu N, Miloslavsky E, Unizony S, Stone JH, Choi HK. Disclaimer. The National Inpatient Sample (NIS) is part of the family of databases and software tools developed for the Healthcare Cost and Utilization Project (HCUP). The focus of this review is to explore and discuss the use of NIS database in colorectal surgery research and to formulate a simplified guide of the data captured for future researchers. Careers. The hospital's ownership/control category is obtained from the American Hospital Association Annual Survey of Hospitals and includes categories for government nonfederal (public), private not-for-profit (voluntary), and private investor-owned (proprietary). Hospitalizations of patients with GPA were associated with higher cost as demonstrated by an adjusted additional mean of $5125 (95% CI: $4719, $5531) for total hospital cost and an adjusted additional mean of $16 841 (95% CI: $15 280, $18 403) for total hospitalization charges when compared with patients without GPA. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The pediatric age spectrum is broad with changing physiology and there are vastly different parameters to be considered for transfusion.18,19 A paucity of comparable data pertaining to transfusion thresholds in this vulnerable age group has precluded establishment of evidence-based guidelines or pediatric PBM programs.2,20, This study has limitations including reliance on ICD-10 billing codes, which may lead to measurement error. K08 HL122527/HL/NHLBI NIH HHS/United States, UL1 TR001105/TR/NCATS NIH HHS/United States, UL1 TR001863/TR/NCATS NIH HHS/United States, R01 HL123980/HL/NHLBI NIH HHS/United States, T32 HL125247/HL/NHLBI NIH HHS/United States. Volume-outcome relationship in pediatric neurotrauma care: analysis of two national databases. Trends and Distribution of In-Hospital Mortality Among Pregnant and The more recent NBCUS shows that there may be no further decrease in utilization between 2017 to 2019 and that utilization of RBC in the United States might have reached a nadir.6 Although single-center studies assessing the effect of COVID-19 on blood transfusion utilization are emerging, national transfusion trend data assessing the impact of COVID-19 on blood utilization will be important but not available for a few years and likely not reflective of long-term trends.25. For comorbidities shown in the upper 1/3, the rate documented in the NSQIP was more than twice that in the NIS. HHS Vulnerability Disclosure, Help Clin Colon Rectal Surg. Copyright 2022 Elsevier Inc. All rights reserved. and transmitted securely. Calendar time was divided into quarters (3 months), yielding 13 quarters over the study period. [Volume and health outcomes: evidence from systematic reviews and from evaluation of Italian hospital data]. Cureus. Data was obtained from the Nationwide Inpatient Sample (NIS) database for 2016 and 2017. 2021 Nov 2;8:713695. doi: 10.3389/fcvm.2021.713695. Federal government websites often end in .gov or .mil. Secure .gov websites use HTTPSA Pagkopoulou E, Soulaidopoulos S, Triantafyllidou E, Malliari A, Kitas GD, Garyfallos A, Dimitroulas T. Front Med (Lausanne). Follow HCUP recommendations for reporting trends with data that include both ICD-9-CM and ICD-10-CM/PCS coding. Careers. It is designed to be representative of health care use overall, making it ideal for performing basic descriptive studies, deriving national estimates, studying costs, studying rare disease, and understanding trends over time. Objectives: Privacy Policy| Mortality, length of stay and cost of hospitalization among - PubMed QPC=(e-1)100%, where is the coefficient for the quarter variable in log binomial regression. Age- and Sex-Specific Trends in Medical Complications After Acute Ischemic Stroke in the United States. The average sample size of studies was 507,352 patients (standard deviation = 2,739,900). Researchers and policymakers use NIS data to identify, track, and analyze trends in health care utilization, access, charges, quality, and outcomes. A total of 79 sampled studies (68.3% [95% CI, 59.3%-77.3%]) among the 1082 NIS studies screened for eligibility did not account for the effects of sampling error, clustering, and stratification; 62 (54.4% [95% CI, 44.7%-64.0%]) extrapolated nonspecific secondary diagnoses to infer in-hospital events; 45 (40.4% [95% CI, 30.9%-50.0%]) miscategorized hospitalizations as individual patients; 10 (7.1% [95% CI, 2.1%-12.1%]) performed state-level analyses; and 3 (2.9% [95% CI, 0.0%-6.2%]) reported physician-level volume estimates. Unable to load your collection due to an error, Unable to load your delegates due to an error, U.S. overall colorectal cancer resection rates by age group. This study was supported in part by grants from the National Institutes of Health (R01AI120938 and R01AI128779 to A.A.R.T, K23HL151826 to E.M.B., T32AI102623 to E.U.P.). Healthcare Cost and Utilization Project (HCUP). The National Inpatient Sample (NIS), sponsored by the Agency for Healthcare Research and Quality (AHRQ) as part of the Healthcare Utilization Project (HCUP), is the largest all-payer administrative database and includes data from a 20% stratified sample of hospitalizations in participating states ( N = 47), representing more than 97% of the Unit. Idolor ON, Guraya A, Muojieje CC, Kannayiram SS, Nair KM, Odion J, Sanwo E, Aihie OP. percent Medicare patients) can be estimated. Questions/purposes: Only conditions, procedures, and diagnostic tests occurring during a specific inpatient hospital encounter are captured in the NIS. Would you like email updates of new search results? Epub 2021 Nov 9. Please enable it to take advantage of the complete set of features! The overall national decrease of transfusions implies lower overall cost burden on hospitals and increased adoption of an evidence-based and patient-centric approach to transfusion medicine. Guide to Statistics and Methods: The National Inpatient Sample Epub 2017 Jun 15. Secondary diagnosis codes in the NIS do not differentiate comorbidities from complications, unless they are specific to in-hospital events captured by a specific ICD code that indicates a complication. Please enable it to take advantage of the complete set of features! This study being limited to the inpatient setting does not capture changes in outpatient utilization. government site. 2023 Feb;9(1):e002752. Accessibility A locked padlock Khera R, Krumholz HM. National Inpatient Sample, the largest all-payer inpatient database representing 94% to 97% of the US population, was evaluated from the fourth quarter (Q4) of 2015 through 2018. 2000; 95: . Aortic stenosis; Endovascular access; Endovascular-TAVR; TA-TAVR; TAVR; Transapical access; Transapical-TAVR; Transcatheter aortic valve replacement. There were 97,320 endovascular-TAVR patients and 11,140 transapical-TAVR patients. The race categories were predefined by Healthcare Cost and Utilization Project (HCUP) and includes race and ethnicity in 1 data element (RACE). National (Nationwide) Inpatient Sample (NIS) - Agency for Healthcare The novel MIP sensor was used to determine OC in cancer patient plasma samples. All analysed data were extracted from the database for the years 2005-2014. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). sharing sensitive information, make sure youre on a federal Only inpatient events are captured in the NIS. Because it does not collect data after patient discharge, it can be implied from the NSQIP data that the NIS does not capture more than of the deaths and surgical site infections occurring during the first 30 postoperative days. The unit of analysis in the NIS is inpatient stays, not individual patients. No physician-level analyses are performed. By continuing to use our site, or clicking "Continue," you are agreeing to our, A Checklist to Elevate the Science of Surgical Database Research, Adil H.Haider,MD, MPH; Karl Y.Bilimoria,MD, MS; Melina R.Kibbe,MD, Tips for Analyzing Large Data Sets From the JAMA Surgery Statistical Editors, Amy H.Kaji,MD, PhD; Alfred W.Rademaker,PhD; TerryHyslop,PhD, To register for email alerts, access free PDF, and more, Get unlimited access and a printable PDF ($40.00), 2023 American Medical Association. Effect of Hypothyroidism on Complications in Patients Undergoing TKA in Indian Population. Fetal and maternal morbidity in pregnant patients with Lupus: a 10-year US nationwide analysis. This emphasizes the importance of being vigilant in prevention and early treatment of infections in SSc patients. In this observational study of the 1082 studies published using the NIS from January 2015 through December 2016, a representative sample of 120 studies was systematically evaluated for adherence to practices required by AHRQ for the design and conduct of research using the NIS. 2022 Nov;47(11):101312. doi: 10.1016/j.cpcardiol.2022.101312. Internet Citation: Checklist for Working with the NIS. Patients hospitalized for AIS with associated paroxysmal or persistent AF were identified from the 2018 national inpatient sample database. Obtain and adhere to the HCUP Nationwide Database Data Use Agreement (DUA). Use of the National Surgical Quality Improvement Program in orthopaedic surgery. National treatment trends, complications, and predictors of in-hospital charges for the surgical management of craniopharyngiomas in adults from 2007 to 2011. Several techniques are available to assess and reduce the impact of missing data when using the NIS. The SID must be used for State-level research. Number of peer-reviewed publications from the National Inpatient Sample (NIS) have increased rapidly in recent years. Wiggins ME, Dion C, Formanski E, Davoudi A, Amini S, Heilman KM, Penney D, Davis R, Garvan CW, Arnaoutakis GJ, Tighe P, Libon DJ, Price CC. Results: N Tornberg H, Cohen JS, Gu A, Wei C, Mortman R, Sculco PK, Thakkar SC, Campbell JC. Clipboard, Search History, and several other advanced features are temporarily unavailable. Data elements include but are not limited to: diagnoses, procedures, discharge status, patient demographics (e.g., gender, age), total charges, length of stay, and expected payment source, including but not limited to Medicare, Medicaid, private insurance, self-pay, or those billed as no charge. We used the National Inpatient Sample (2012-13) to identify adult hospitalizations with SSc, excluding patients with concomitant diagnosis of RA and systemic lupus. HCUP-US NIS Overview 2023 May 3;36(4):427-433. doi: 10.1080/08998280.2023.2204535. Bookshelf The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Risk Factors for Respiratory Failure in Patients Hospitalized With Systemic Sclerosis: An Analysis of the National Inpatient Sample. value was calculated for these linear trend tests. Rockville (MD): Agency for Healthcare Research and Quality (US); 2006 Feb. Molina CS, Thakore RV, Blumer A, Obremskey WT, Sethi MK. Keywords: The site is secure. Federal government websites often end in .gov or .mil. J Neurosurg Spine. 8600 Rockville Pike Comorbidities common to both databases were compared in terms of more or less than twofold difference between the two databases. Kellish AS, Shahi A, Rodriguez JA Jr, Usmani K, Boniello M, Oliashirazi A, Graf K, Dolch H, Fuller D, Mashru RP. Please enable it to take advantage of the complete set of features! The NIS can be used to estimate incidence or prevalence of both common and rare conditions in some, but not all scenarios. Arthritis Care Res (Hoboken). Agency for Healthcare Research and Quality, Identifying existing Choosing Wisely recommendations of high relevance and importance to hematology, Evidence-based practice guidelines for plasma transfusion, The effect of plasma transfusion on morbidity and mortality: a systematic review and meta-analysis, Cryoprecipitate: the current state of knowledge, Effect of fibrinogen concentrate vs cryoprecipitate on blood component transfusion after cardiac surgery: the FIBRES randomized clinical trial, Increased number of coagulation products in relationship to red blood cell products transfused improves mortality in trauma patients, Recent advances in use of fresh frozen plasma, cryoprecipitate, immunoglobulins, and clotting factors for transfusion support in patients with hematologic disease, Fibrinogen as a therapeutic target for bleeding: a review of critical levels and replacement therapy, Quality of evidence-based guidelines for platelet transfusion and use: A systematic review, AABB Platelet Transfusion Guidelines Panel, Platelet transfusion: a systematic review of the clinical evidence, Society for the advancement of blood management administrative and clinical standards for patient blood management programs. To characterize inpatient epidemiology and economic burden of granulomatosis with polyangiitis (GPA). We identified a canonical, 4-step protocol for NIS analysis: study population selection; defining additional clinical variables; identification and coding of outcomes; and statistical analysis. Epub 2020 May 19. 2023 Feb 15;15 (2):e35039. Breast Surgical Oncology Epidemiologic Research: A Guide and Comparison of Four National Databases. Epub 2022 Oct 18. In terms of inpatient adverse events, the frequencies of acute kidney injury and urinary tract infection in the NIS were more than twice those in the NSQIP. and transmitted securely. PMC A retrospective cohort study of patients undergoing operative stabilization of transcervical and intertrochanteric hip fractures during 2009 to 2011 was performed in the NIS and NSQIP. NCI CPTC Antibody Characterization Program. doi: 10.7759/cureus.35797. Healthcare Cost and Utilization Project; National Inpatient Sample; colorectal. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Kids' Inpatient Database (KID) KID Database Documentation. Unauthorized use of these marks is strictly prohibited. Myocarditis | NEJM An estimated 925 (95% CI, 852-998) NIS publications did not adhere to 1 or more required practices and 696 (95% CI, 596-796) NIS publications did not adhere to 2 or more required practices. This site needs JavaScript to work properly. Many of the ideas we discuss will be applicable to the entire HCUP suite (Table). Adherence to Methodological Standards in Research Using the National Morbidity and Mortality in Non-Obese Compared to Different Classes of Obesity in Patients Undergoing Transtibial Amputations. This site needs JavaScript to work properly. The data were collected from January 2016 to December 2017 Nationwide Inpatient Sample. 2015 May;473(5):1574-81. doi: 10.1007/s11999-014-3597-7. 2023 American Medical Association. Before National Trends of Outcomes in Transcatheter Aortic Valve - PubMed eCollection 2023. Amato L, Colais P, Davoli M, Ferroni E, Fusco D, Minozzi S, Moirano F, Sciattella P, Vecchi S, Ventura M, Perucci CA. Epub 2019 Jan 8. In contrast with decreasing rates in adults eligible for screening, increasing rates were observed in younger adults. 8600 Rockville Pike 2002 May-Jun;5(3):143-51. National Inpatient Sample (NIS) - Restricted Access Files sharing sensitive information, make sure youre on a federal This site needs JavaScript to work properly. See the Instructions for Authors for a complete description of levels of evidence. and transmitted securely. The eye is a common site of granulomatosis with polyangiitis. and transmitted securely. U.S. overall colorectal cancer resection, U.S. overall colorectal cancer resection rates by age group. 2023 Mar 21;100(12):e1282-e1295. Epub 2013 Nov 29. This could stem from the increasing recognition that acquired hypofibrinogenemia contributes to hemorrhage,11 fibrinogen concentrates, and cryoprecipitate, garnering increased attention12 and wider adoption of hemostasis testing that leads to increased usage of cryoprecipitate.13-15 Although clinical practice guidelines recommend prophylactic platelet transfusions,3 the evidence supporting platelet transfusions in specific clinical indications has been rated as low/very-low quality by GRADE methodology and there are inconsistent recommendations across various guidelines.16,17 Although Patient Blood Management (PBM) initiatives appear to be effective in restricting RBC and plasma transfusions nationwide, targeted interventions are needed for platelets. Hierarchical linear modeling (HLM) is one way to account for this design aspect of the NIS. Metadata Updated: May 2, 2023. Nationally representative administrative studies and surveys in the United States have previously shown a decline in blood utilization, particularly RBCs, with a concomitant reduction in blood collection of selected components.4-6 This study evaluated contemporary national trends in RBC, plasma, platelet, and cryoprecipitate transfusions among inpatient hospitalizations in the United States (2015-2018). Cureus. For events shown in the upper , the rate documented in the NIS and the rate documented in the NSQIP before discharge were within a twofold difference of each other. Records of events and diagnoses before or after the stay are not available. Careers. Authors The .gov means its official. Restricted access data files are available with a data use agreement and brief online security training. The NIS's large sample size enables analyses of rare conditions, such as congenital anomalies; uncommon treatments, such as organ transplantation; and special patient populations, such as the uninsured. The decline in RBC and plasma transfusions suggests steady incorporation of robust evidence base showing safety of restrictive transfusions. The National Inpatient Sample database was used to collect data for hospitalizations of patients 20 years old with primary diagnosis of PE between January 2000 and September 2015. 2021 Dec 2;9(12):1426. doi: 10.3390/vaccines9121426. NIS uses a multistaged clustering design to develop a stratified probability sample of 20% of all inpatient discharges, representing approximately 94% to 97% of the US population across the included years 2015 through 2018. Epub 2023 Mar 28. Epub 2022 Jul 14. RBCs are the most commonly transfused blood component in the United States, and RBC transfusion is the most common procedure among hospitalized patients.7 The Joint Commission and American Society of Hematology have targeted RBC transfusions as one of the most overused procedures in the US hospitals.8 Although data and guidelines pertaining to plasma utilization are limited, plasma use historically follows RBC transfusion trends.4,9,10 By contrast, this study demonstrated a national increase in cryoprecipitate utilization. Demographics and hospital lengths of stay were not different between the two databases. Rockville, MD 20857 doi:10.1001/jamasurg.2018.0542. Notably, the 2019 National Blood Collection Utilization Survey (NBCUS) showed an overall 15% increase in transfusion between 2017 and 2019 for apheresis and whole blood-derived platelet units combined.23, Data by the AABB and Centers for Disease Control and Prevention that focused on number of units of blood collected suggested a decline in the total number of RBC units transfused may have begun as early as 2008.5,24 The current study demonstrates the trend has continued through at least 2018. Before The https:// ensures that you are connecting to the Conclusion: They do not need IRB approval, these studies are IRB exempted. 2021 Dec 1;13(12):e20089. Epub 2023 Jan 4. Starting from the fourth quarter (Q4) of 2015, International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) procedure codes were reported in the NIS, which were used to identify percent of hospitalizations with 1 RBC, plasma, platelet, and cryoprecipitate transfusions (separate outcomes). Clipboard, Search History, and several other advanced features are temporarily unavailable. Among the endovascular-TAVR group, national trends showed a diminishing incidence of procedural mortality (incidence rate ratio [IRR] 0.77; 95% CI: 0.72-0.84, p < 0.001), stroke (IRR 0.80; 95% CI: 0.73-0.87, p < 0.001), and all secondary outcomes, but no significant change in myocardial infarction. Blood transfusions are some of the most common therapeutic procedures performed in hospitalized patients. The inpatient prevalence of GPA was 32.6 cases per 100 000 admissions. The numbers of orthopaedic surgery publications using the NIS and NSQIP per year since 2000 based on a PubMed search of the 41 orthopaedic journals identified by Moverley et al. Analyses were weighted to account for the sampling design and generate nationally representative estimates. The data represent weighted estimates for 10 million weighted discharges per quarter in the National Inpatient Sample (2015Q4-2018). 2022 Dec 29;12(1):267. doi: 10.3390/jcm12010267. : 18-05239-EF-1. Simulation of Data to Demonstrate Incorrect Assessment of Hospitalization-level Trends, MeSH Murdaca G, Noberasco G, Olobardi D, Lunardi C, Maule M, Delfino L, Triggiani M, Cardamone C, Benfaremo D, Moroncini G, Vacca A, Susca N, Gangemi S, Quattrocchi P, Sticchi L, Icardi G, Orsi A. An official website of the United States government. Results: government site. If the source supplied race and ethnicity in separate data elements, ethnicity takes precedence over race in setting the HCUP value for race. Age, sex, fracture type, and lengths of stay were compared. Jain V, Minhas AMK, Kleiman NS, Arshad HB, Saleh Y, Pandat SS, Dani SS, Goel SS, Faza N, Butt SA, Blankstein R, Cainzos-Achirica M, Nasir K, Khan SU. Agency for Healthcare Research and Quality, Rockville, MD. Ptrend was calculated using log binomial regression. 2023 American Medical Association. Cardiac Arrest in Young Adults With Ischemic Heart Disease in the United States, 2004-2018. Effect of comorbidities on ischemic stroke mortality: An analysis of the National Inpatient Sample (NIS) Database. In-hospital outcomes of transapical versus surgical aortic valve replacement: from the U.S. national inpatient sample. Managed by the Agency for Healthcare Research and Quality, the Healthcare Cost and Utilization Project (HCUP, pronounced H-Cup) is a collection of data sets that represent the largest collection of administrative, longitudinal health care data in the United States. GPA itself (38.3%), pneumonia (13.7%) and sepsis (8.4%) were the most common reasons for admission. 2021;2:110-121. doi: 10.37349/emed.2021.00036. Renal Involvement in Granulomatosis With Polyangiitis Increases Economic Health Care Burden: Insights From the National Inpatient Sample Database. The proportion of hospitalizations with an RBC transfusion decreased from 4.22% in 2015Q4 to 3.79% in 2018Q4 (QPC = 0.72; 95% confidence interval [CI], 1.26 to 0.19; Ptrend = .008) (Figure 1). BMJ Qual Saf. 2023 Mar 7;15(3):e35878. In the middle 1/3, the rates documented in the two databases were within a twofold difference of each other. Nationwide Ambulatory Surgery Sample (NASS) Patients with GPA were identified from the Nationwide Inpatient Sample (NIS), the largest inpatient database in the USA consisting of over 4000 non-federal acute care hospitals, using the ICD-9 CM code. The Author(s) 2020. Federal government websites often end in .gov or .mil. Checklist for Working with the NIS - Agency for Healthcare Research and official website and that any information you provide is encrypted . sharing sensitive information, make sure youre on a federal https://pubmed.ncbi.nlm.nih.gov/11051351/ Am J Gastroenterol. Yao S, Yang R, Du C, Jiang C, Wang Y, Peng C, Bai H. Front Oncol. Trends of Co-Morbid Depression in Hospitalized Patients with Failed Back Surgery Syndrome: An Analysis of the Nationwide Inpatient Sample. PMC In general, the declines in transfusions followed those groups with the highest prevalence of transfusions in 2015. In contrast, hospitalizations with cryoprecipitate utilization significantly increased QPC = 2.01 (95% CI, 0.57 to 3.44; Ptrend = .006). The data represent weighted estimates for approximately 40 million weighted discharges per year in the National Inpatient Sample (2015Q4-2018). With Great Power Comes Great Responsibility: "Big Data" Research from The data are collected from state organizations, hospital associations, private organizations, and the federal government. government site. See this image and copyright information in PMC. The site is secure. Recommendations for Reporting Trends Using ICD-9-CM and ICD-10-CM/PCS Data, http://circoutcomes.ahajournals.org/content/10/7/e003846.long, https://jamanetwork.com/journals/jama/article-abstract/2664461. Flu and Pneumococcal Vaccine Coverage in Scleroderma Patients Still Need to Be Prompted: A Systematic Review. Treppo E, Binutti M, Agarinis R, De Vita S, Quartuccio L. J Clin Med. The NIS does not include physician identifiers. Infections were the most common primary diagnoses among SSc hospitalizations (17.4%) and among those who died (32.7%).
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