BACKGROUND Chronic liver disease is associated with various neuropsychiatric conditions.There are currently no large studies assessing and comparing the prevalence of psy-chiatric illnesses based on patient profiles a...BACKGROUND Chronic liver disease is associated with various neuropsychiatric conditions.There are currently no large studies assessing and comparing the prevalence of psy-chiatric illnesses based on patient profiles and the etiology of cirrhosis.AIM To examine the trends of hospitalizations among psychiatric conditions in cirrhosis.METHODS We used the National Inpatient Sample database 2016-2019 for the primary diagnosis of liver cirrhosis.The outcomes included the prevalence,trends,and associations of psychiatric diagnoses in these hospitalizations.Chi-square for categorical variables and the Wilcoxon rank test for continuous variables were utilized.RESULTS 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 2019.Cirrhosis 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 causes.Alcohol-and NAFLD-associated cirrhosis had a stronger link to psychiatric disorders.Females 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 males.Blacks,Hispanics,and Asian/Native Americans had a significantly lower association with GAD,depression,bipolar disorder,PTSD,and ADHD when compared to the white race.CONCLUSION The prevalence of psychiatric comorbidities in liver cirrhosis hospitalizations has increased over the last decade.Females had a higher association with psychiatric disorders compared to males.Blacks,Hispanics,and Asian/Native Americans had lower associations with psychiatric comorbidities compared to the white race.展开更多
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 patie...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 AP.Methods: 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 screens.Results: 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.展开更多
文摘BACKGROUND Chronic liver disease is associated with various neuropsychiatric conditions.There are currently no large studies assessing and comparing the prevalence of psy-chiatric illnesses based on patient profiles and the etiology of cirrhosis.AIM To examine the trends of hospitalizations among psychiatric conditions in cirrhosis.METHODS We used the National Inpatient Sample database 2016-2019 for the primary diagnosis of liver cirrhosis.The outcomes included the prevalence,trends,and associations of psychiatric diagnoses in these hospitalizations.Chi-square for categorical variables and the Wilcoxon rank test for continuous variables were utilized.RESULTS 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 2019.Cirrhosis 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 causes.Alcohol-and NAFLD-associated cirrhosis had a stronger link to psychiatric disorders.Females 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 males.Blacks,Hispanics,and Asian/Native Americans had a significantly lower association with GAD,depression,bipolar disorder,PTSD,and ADHD when compared to the white race.CONCLUSION The prevalence of psychiatric comorbidities in liver cirrhosis hospitalizations has increased over the last decade.Females had a higher association with psychiatric disorders compared to males.Blacks,Hispanics,and Asian/Native Americans had lower associations with psychiatric comorbidities compared to the white race.
文摘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 AP.Methods: 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 screens.Results: 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.
