Epidemiologic Trends in Pleural Infection. A Nationwide Analysis.
Ishaan GuptaShaker M EidErin A GillaspieStephen BroderickMajid ShafiqPublished in: Annals of the American Thoracic Society (2021)
Rationale: Recent trends in the care and outcomes of pleural infection are not well characterized.Objectives: To investigate trends in hospital-based healthcare use, outcomes, and management of pleural infection across the United States.Methods: We identified adult hospitalizations for pleural infection from 2005 through 2014 in the Healthcare Cost and Utilization Project-National Inpatient Sample using International Classification of Diseases, Ninth Edition Clinical Modification diagnosis codes. We calculated weighted estimates of national trends in hospitalization, hospital length of stay, hospital mortality, inflation-adjusted cost, and management practices. We tested trend significance using fitted regression models.Results: Over one decade, there was a significant decline in hospitalizations (54.4 per million to 41.2 per million U.S. adult population), length of stay (13.5 ± 0.2 to 11.2 ± 0.2 d), mortality (4.2-2.6%), and costs ($32,829 to $29,458) (all P < 0.001). Both tube thoracostomy and video-assisted thoracoscopic surgery saw an increase as the procedure of first choice, along with declining use of thoracotomy (all P < 0.001). Most patients who underwent video-assisted thoracoscopic surgery (94%) or tube thoracostomy (64.9%) as the initial procedure did not require a second invasive procedure.Conclusions: Over the 21st century's first decade and a half, inpatient costs, use, and mortality have improved among U.S. adults hospitalized with pleural infection. Simultaneously, there has been a shift toward less invasive interventions upfront.
Keyphrases
- healthcare
- minimally invasive
- quality improvement
- cardiovascular events
- palliative care
- end stage renal disease
- mental health
- primary care
- acute care
- type diabetes
- machine learning
- robot assisted
- magnetic resonance imaging
- emergency department
- clinical trial
- chronic kidney disease
- physical activity
- computed tomography
- prognostic factors
- peritoneal dialysis
- left ventricular
- social media
- chronic pain
- transcatheter aortic valve replacement
- decision making
- acute coronary syndrome
- health insurance
- health information
- affordable care act
- electronic health record