Understanding the Influence of Hospital Volume on Inpatient Outcomes Following Hospitalization for Status Epilepticus
Background Prior studies show hospital admission volume to be associated with poor outcomes following elective procedures and inpatient medical hospitalizations. However, it is unknown whether hospital volume impacts Inpatient outcomes for status epilepticus (SE) hospitalizations. In this study, we...
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| Veröffentlicht in: | Neurocritical care 2023-02, Vol.38 (1), p.26-34 |
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| creator | Syed, Maryam J. Zutshi, Deepti Khawaja, Ayaz Basha, Maysaa M. Marawar, Rohit |
| description | Background
Prior studies show hospital admission volume to be associated with poor outcomes following elective procedures and inpatient medical hospitalizations. However, it is unknown whether hospital volume impacts Inpatient outcomes for status epilepticus (SE) hospitalizations. In this study, we aimed to assess the impact of hospital volume on the outcome of patients with SE and related inpatient medical complications.
Methods
The 2005 to 2013 National Inpatient Sample database was queried using International Classification of Diseases 9th Edition diagnosis code 345.3 to identify patients undergoing acute hospitalization for SE. The National Inpatient Sample hospital identifier was used as a unique facility identifier to calculate the average volume of patients with SE seen in a year. The study cohort was divided into three groups: low volume (0–7 patients with SE per year), medium volume (8–22 patients with SE per year), and high volume (> 22 patients with SE per year). Multivariate logistic regression analyses were used to assess whether medium or high hospital volume had lower rates of inpatient medical complications compared with low-volume hospitals.
Results
A total of 137,410 patients with SE were included in the analysis. Most patients (
n
= 50,939; 37%) were treated in a low-volume hospital, 31% (
n
= 42,724) were treated in a medium-volume facility, and 18% (
n
= 25,207) were treated in a high-volume hospital. Patients undergoing treatment at medium-volume hospitals (vs. low-volume hospitals) had higher odds of pulmonary complications (odds ratio [OR] 1.18 [95% confidence interval {CI} 1.12–1.25];
p
|
| doi_str_mv | 10.1007/s12028-022-01656-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2755574677</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2919735858</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-ef7536eef2e142e05900d3bf2f01543dde5748702ea7b9efa800225a0741421f3</originalsourceid><addsrcrecordid>eNp9kclKBDEQhoMo7i_gQQJevLRmmXS6jyJuIHhwuYZMd0Vb0kmbBdGnN-O4gAdPVVR99VcVP0J7lBxRQuRxpIywpiKMVYTWoq74CtqkoiSkrenqIp_Rqm4530BbMT4TwmQrxTra4LVgTFCxifK96yHEpF0_uEecngBfOWMzuA6wN_jSx2lI2uIHb_NYSq70J50GcAnf5NT5ESI-99b614XANz-8F6bAxgd8m3TKEZ9Ng4UpDV2OO2jNaBth9ytuo_vzs7vTy-r65uLq9OS66jirUwVGCl4DGAZ0xoCIlpCezw0zpLzG-x6EnDWSMNBy3oLRTXmRCU3krPDU8G10uNSdgn_JEJMah9iBtdqBz1ExKUSRqKUs6MEf9Nnn4Mp1irW0lVw0oikUW1Jd8DEGMGoKw6jDm6JELUxRS1NUuUN9mqJ4Gdr_ks7zEfqfkW8XCsCXQCwt9wjhd_c_sh_JDJho</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2919735858</pqid></control><display><type>article</type><title>Understanding the Influence of Hospital Volume on Inpatient Outcomes Following Hospitalization for Status Epilepticus</title><source>AUTh Library subscriptions: ProQuest Central</source><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><source>ProQuest Central (Alumni)</source><source>ProQuest Central</source><creator>Syed, Maryam J. ; Zutshi, Deepti ; Khawaja, Ayaz ; Basha, Maysaa M. ; Marawar, Rohit</creator><creatorcontrib>Syed, Maryam J. ; Zutshi, Deepti ; Khawaja, Ayaz ; Basha, Maysaa M. ; Marawar, Rohit</creatorcontrib><description><![CDATA[Background
Prior studies show hospital admission volume to be associated with poor outcomes following elective procedures and inpatient medical hospitalizations. However, it is unknown whether hospital volume impacts Inpatient outcomes for status epilepticus (SE) hospitalizations. In this study, we aimed to assess the impact of hospital volume on the outcome of patients with SE and related inpatient medical complications.
Methods
The 2005 to 2013 National Inpatient Sample database was queried using International Classification of Diseases 9th Edition diagnosis code 345.3 to identify patients undergoing acute hospitalization for SE. The National Inpatient Sample hospital identifier was used as a unique facility identifier to calculate the average volume of patients with SE seen in a year. The study cohort was divided into three groups: low volume (0–7 patients with SE per year), medium volume (8–22 patients with SE per year), and high volume (> 22 patients with SE per year). Multivariate logistic regression analyses were used to assess whether medium or high hospital volume had lower rates of inpatient medical complications compared with low-volume hospitals.
Results
A total of 137,410 patients with SE were included in the analysis. Most patients (
n
= 50,939; 37%) were treated in a low-volume hospital, 31% (
n
= 42,724) were treated in a medium-volume facility, and 18% (
n
= 25,207) were treated in a high-volume hospital. Patients undergoing treatment at medium-volume hospitals (vs. low-volume hospitals) had higher odds of pulmonary complications (odds ratio [OR] 1.18 [95% confidence interval {CI} 1.12–1.25];
p
< 0.001), sepsis (OR 1.24 [95% CI 1.08–1.43]
p
= 0.002), and length of stay (OR 1.13 [95% CI 1.0 –1.19]
p
< 0.001). High-volume hospitals had significantly higher odds of urinary tract infections (OR 1.21 [95% CI 1.11–1.33]
p
< 0.001), pulmonary complications (OR 1.19 [95% CI 1.10–1.28],
p
< 0.001), thrombosis (OR 2.13 [95% CI 1.44–3.14],
p
< 0.001), and renal complications (OR 1.21 [95% CI 1.07–1.37],
p
= 0.002). In addition, high-volume hospitals had lower odds of metabolic (OR 0.81 [95% CI 0.72–0.91],
p
< 0.001), neurological complications (OR 0.80 [95% CI 0.69–0.93],
p
= 0.004), and disposition to a facility (OR 0.89 [95% CI 0.82–0.96],
p
< 0.001) compared with lower-volume hospitals.
Conclusions
Our study demonstrates certain associations between hospital volume and outcomes for SE hospitalizations. Further studies using more granular data about the type, severity, and duration of SE and types of treatment are warranted to better understand how hospital volume may impact care and prognosis of patients.]]></description><identifier>ISSN: 1541-6933</identifier><identifier>EISSN: 1556-0961</identifier><identifier>DOI: 10.1007/s12028-022-01656-3</identifier><identifier>PMID: 36522515</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Critical Care Medicine ; Databases, Factual ; Demographics ; Diabetes ; Emergency medical care ; Family income ; Hospitalization ; Hospitals ; Hospitals, High-Volume ; Humans ; Inpatients ; Intensive ; Internal Medicine ; Length of Stay ; Medicine ; Medicine & Public Health ; Mortality ; Neurology ; Neurosurgery ; Original Work ; Patients ; Regression analysis ; Statistical analysis ; Status Epilepticus - epidemiology ; Status Epilepticus - therapy ; Thrombosis</subject><ispartof>Neurocritical care, 2023-02, Vol.38 (1), p.26-34</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society 2022. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2022. Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-ef7536eef2e142e05900d3bf2f01543dde5748702ea7b9efa800225a0741421f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12028-022-01656-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2919735858?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,21388,21389,27924,27925,33530,33531,33744,33745,41488,42557,43659,43805,51319,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36522515$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Syed, Maryam J.</creatorcontrib><creatorcontrib>Zutshi, Deepti</creatorcontrib><creatorcontrib>Khawaja, Ayaz</creatorcontrib><creatorcontrib>Basha, Maysaa M.</creatorcontrib><creatorcontrib>Marawar, Rohit</creatorcontrib><title>Understanding the Influence of Hospital Volume on Inpatient Outcomes Following Hospitalization for Status Epilepticus</title><title>Neurocritical care</title><addtitle>Neurocrit Care</addtitle><addtitle>Neurocrit Care</addtitle><description><![CDATA[Background
Prior studies show hospital admission volume to be associated with poor outcomes following elective procedures and inpatient medical hospitalizations. However, it is unknown whether hospital volume impacts Inpatient outcomes for status epilepticus (SE) hospitalizations. In this study, we aimed to assess the impact of hospital volume on the outcome of patients with SE and related inpatient medical complications.
Methods
The 2005 to 2013 National Inpatient Sample database was queried using International Classification of Diseases 9th Edition diagnosis code 345.3 to identify patients undergoing acute hospitalization for SE. The National Inpatient Sample hospital identifier was used as a unique facility identifier to calculate the average volume of patients with SE seen in a year. The study cohort was divided into three groups: low volume (0–7 patients with SE per year), medium volume (8–22 patients with SE per year), and high volume (> 22 patients with SE per year). Multivariate logistic regression analyses were used to assess whether medium or high hospital volume had lower rates of inpatient medical complications compared with low-volume hospitals.
Results
A total of 137,410 patients with SE were included in the analysis. Most patients (
n
= 50,939; 37%) were treated in a low-volume hospital, 31% (
n
= 42,724) were treated in a medium-volume facility, and 18% (
n
= 25,207) were treated in a high-volume hospital. Patients undergoing treatment at medium-volume hospitals (vs. low-volume hospitals) had higher odds of pulmonary complications (odds ratio [OR] 1.18 [95% confidence interval {CI} 1.12–1.25];
p
< 0.001), sepsis (OR 1.24 [95% CI 1.08–1.43]
p
= 0.002), and length of stay (OR 1.13 [95% CI 1.0 –1.19]
p
< 0.001). High-volume hospitals had significantly higher odds of urinary tract infections (OR 1.21 [95% CI 1.11–1.33]
p
< 0.001), pulmonary complications (OR 1.19 [95% CI 1.10–1.28],
p
< 0.001), thrombosis (OR 2.13 [95% CI 1.44–3.14],
p
< 0.001), and renal complications (OR 1.21 [95% CI 1.07–1.37],
p
= 0.002). In addition, high-volume hospitals had lower odds of metabolic (OR 0.81 [95% CI 0.72–0.91],
p
< 0.001), neurological complications (OR 0.80 [95% CI 0.69–0.93],
p
= 0.004), and disposition to a facility (OR 0.89 [95% CI 0.82–0.96],
p
< 0.001) compared with lower-volume hospitals.
Conclusions
Our study demonstrates certain associations between hospital volume and outcomes for SE hospitalizations. Further studies using more granular data about the type, severity, and duration of SE and types of treatment are warranted to better understand how hospital volume may impact care and prognosis of patients.]]></description><subject>Critical Care Medicine</subject><subject>Databases, Factual</subject><subject>Demographics</subject><subject>Diabetes</subject><subject>Emergency medical care</subject><subject>Family income</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Hospitals, High-Volume</subject><subject>Humans</subject><subject>Inpatients</subject><subject>Intensive</subject><subject>Internal Medicine</subject><subject>Length of Stay</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Neurology</subject><subject>Neurosurgery</subject><subject>Original Work</subject><subject>Patients</subject><subject>Regression analysis</subject><subject>Statistical analysis</subject><subject>Status Epilepticus - epidemiology</subject><subject>Status Epilepticus - therapy</subject><subject>Thrombosis</subject><issn>1541-6933</issn><issn>1556-0961</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kclKBDEQhoMo7i_gQQJevLRmmXS6jyJuIHhwuYZMd0Vb0kmbBdGnN-O4gAdPVVR99VcVP0J7lBxRQuRxpIywpiKMVYTWoq74CtqkoiSkrenqIp_Rqm4530BbMT4TwmQrxTra4LVgTFCxifK96yHEpF0_uEecngBfOWMzuA6wN_jSx2lI2uIHb_NYSq70J50GcAnf5NT5ESI-99b614XANz-8F6bAxgd8m3TKEZ9Ng4UpDV2OO2jNaBth9ytuo_vzs7vTy-r65uLq9OS66jirUwVGCl4DGAZ0xoCIlpCezw0zpLzG-x6EnDWSMNBy3oLRTXmRCU3krPDU8G10uNSdgn_JEJMah9iBtdqBz1ExKUSRqKUs6MEf9Nnn4Mp1irW0lVw0oikUW1Jd8DEGMGoKw6jDm6JELUxRS1NUuUN9mqJ4Gdr_ks7zEfqfkW8XCsCXQCwt9wjhd_c_sh_JDJho</recordid><startdate>20230201</startdate><enddate>20230201</enddate><creator>Syed, Maryam J.</creator><creator>Zutshi, Deepti</creator><creator>Khawaja, Ayaz</creator><creator>Basha, Maysaa M.</creator><creator>Marawar, Rohit</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20230201</creationdate><title>Understanding the Influence of Hospital Volume on Inpatient Outcomes Following Hospitalization for Status Epilepticus</title><author>Syed, Maryam J. ; Zutshi, Deepti ; Khawaja, Ayaz ; Basha, Maysaa M. ; Marawar, Rohit</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-ef7536eef2e142e05900d3bf2f01543dde5748702ea7b9efa800225a0741421f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Critical Care Medicine</topic><topic>Databases, Factual</topic><topic>Demographics</topic><topic>Diabetes</topic><topic>Emergency medical care</topic><topic>Family income</topic><topic>Hospitalization</topic><topic>Hospitals</topic><topic>Hospitals, High-Volume</topic><topic>Humans</topic><topic>Inpatients</topic><topic>Intensive</topic><topic>Internal Medicine</topic><topic>Length of Stay</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Neurology</topic><topic>Neurosurgery</topic><topic>Original Work</topic><topic>Patients</topic><topic>Regression analysis</topic><topic>Statistical analysis</topic><topic>Status Epilepticus - epidemiology</topic><topic>Status Epilepticus - therapy</topic><topic>Thrombosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Syed, Maryam J.</creatorcontrib><creatorcontrib>Zutshi, Deepti</creatorcontrib><creatorcontrib>Khawaja, Ayaz</creatorcontrib><creatorcontrib>Basha, Maysaa M.</creatorcontrib><creatorcontrib>Marawar, Rohit</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Neurocritical care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Syed, Maryam J.</au><au>Zutshi, Deepti</au><au>Khawaja, Ayaz</au><au>Basha, Maysaa M.</au><au>Marawar, Rohit</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Understanding the Influence of Hospital Volume on Inpatient Outcomes Following Hospitalization for Status Epilepticus</atitle><jtitle>Neurocritical care</jtitle><stitle>Neurocrit Care</stitle><addtitle>Neurocrit Care</addtitle><date>2023-02-01</date><risdate>2023</risdate><volume>38</volume><issue>1</issue><spage>26</spage><epage>34</epage><pages>26-34</pages><issn>1541-6933</issn><eissn>1556-0961</eissn><abstract><![CDATA[Background
Prior studies show hospital admission volume to be associated with poor outcomes following elective procedures and inpatient medical hospitalizations. However, it is unknown whether hospital volume impacts Inpatient outcomes for status epilepticus (SE) hospitalizations. In this study, we aimed to assess the impact of hospital volume on the outcome of patients with SE and related inpatient medical complications.
Methods
The 2005 to 2013 National Inpatient Sample database was queried using International Classification of Diseases 9th Edition diagnosis code 345.3 to identify patients undergoing acute hospitalization for SE. The National Inpatient Sample hospital identifier was used as a unique facility identifier to calculate the average volume of patients with SE seen in a year. The study cohort was divided into three groups: low volume (0–7 patients with SE per year), medium volume (8–22 patients with SE per year), and high volume (> 22 patients with SE per year). Multivariate logistic regression analyses were used to assess whether medium or high hospital volume had lower rates of inpatient medical complications compared with low-volume hospitals.
Results
A total of 137,410 patients with SE were included in the analysis. Most patients (
n
= 50,939; 37%) were treated in a low-volume hospital, 31% (
n
= 42,724) were treated in a medium-volume facility, and 18% (
n
= 25,207) were treated in a high-volume hospital. Patients undergoing treatment at medium-volume hospitals (vs. low-volume hospitals) had higher odds of pulmonary complications (odds ratio [OR] 1.18 [95% confidence interval {CI} 1.12–1.25];
p
< 0.001), sepsis (OR 1.24 [95% CI 1.08–1.43]
p
= 0.002), and length of stay (OR 1.13 [95% CI 1.0 –1.19]
p
< 0.001). High-volume hospitals had significantly higher odds of urinary tract infections (OR 1.21 [95% CI 1.11–1.33]
p
< 0.001), pulmonary complications (OR 1.19 [95% CI 1.10–1.28],
p
< 0.001), thrombosis (OR 2.13 [95% CI 1.44–3.14],
p
< 0.001), and renal complications (OR 1.21 [95% CI 1.07–1.37],
p
= 0.002). In addition, high-volume hospitals had lower odds of metabolic (OR 0.81 [95% CI 0.72–0.91],
p
< 0.001), neurological complications (OR 0.80 [95% CI 0.69–0.93],
p
= 0.004), and disposition to a facility (OR 0.89 [95% CI 0.82–0.96],
p
< 0.001) compared with lower-volume hospitals.
Conclusions
Our study demonstrates certain associations between hospital volume and outcomes for SE hospitalizations. Further studies using more granular data about the type, severity, and duration of SE and types of treatment are warranted to better understand how hospital volume may impact care and prognosis of patients.]]></abstract><cop>New York</cop><pub>Springer US</pub><pmid>36522515</pmid><doi>10.1007/s12028-022-01656-3</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1541-6933 |
| ispartof | Neurocritical care, 2023-02, Vol.38 (1), p.26-34 |
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| language | eng |
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| source | AUTh Library subscriptions: ProQuest Central; MEDLINE; Springer Nature - Complete Springer Journals; ProQuest Central (Alumni); ProQuest Central |
| subjects | Critical Care Medicine Databases, Factual Demographics Diabetes Emergency medical care Family income Hospitalization Hospitals Hospitals, High-Volume Humans Inpatients Intensive Internal Medicine Length of Stay Medicine Medicine & Public Health Mortality Neurology Neurosurgery Original Work Patients Regression analysis Statistical analysis Status Epilepticus - epidemiology Status Epilepticus - therapy Thrombosis |
| title | Understanding the Influence of Hospital Volume on Inpatient Outcomes Following Hospitalization for Status Epilepticus |
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