Disorders of the Pleura: Impact of Pleural Disorders |

Inpatient Admissions for Malignant Pleural Effusions in the United States: Data From the 2012 National Inpatient Sample (HCUP-NIS) FREE TO VIEW

Niloofar Taghizadeh, PhD; Marc Fortin, MD; Alain Tremblay, MD
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Division of Respiratory Medicine, University of Calgary and Alberta Thoracic Oncology Program, Calgary, AB, Canada

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):580A. doi:10.1016/j.chest.2016.08.669
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SESSION TITLE: Impact of Pleural Disorders

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Monday, October 24, 2016 at 07:30 AM - 08:30 AM

PURPOSE: While malignant pleural effusions (MPE) are a common complication of advanced malignancy, little is known regarding the prevalence and overall burden of MPE on a population level.

METHODS: We conducted a retrospective analysis using the Healthcare Cost and Utilization Project -Nationwide Inpatient Sample, Agency for Healthcare Research and Quality (HCUP-NIS 2012). The International Classification of Diseases, Ninth Revision, and Clinical Modification (ICD-9-CM) was used to select patients with MPE. Cases were included if MPE was coded as a primary or secondary diagnosis or if an unspecified pleural effusion was coded in addition to a diagnosis of cancer. Descriptive analyses were used to determine the prevalence demographics, and clinical characteristics of patients with MPE, using a weighted analysis to produce national estimates of US hospitalizations. In addition, we analyzed the association between selected predictors and inpatient mortality using univariate and multivariate logistic regression models.

RESULTS: A weighted sample of 126,825 (0.35 %) admissions for MPE was identified among the 36,484,846 weighted admissions included in the database. Of these patients, 70,750 (55.8 %) were female, and 88,150 (69.5 %) were Caucasian. The median, interquartile range (IQR) age at admission was 68.0 (58.4-77.2). MPE was more commonly diagnosed in patients with Medicare insurance and in the lower income quartile. Lung (37.8%), breast (15.2%), hematologic (11.2%), GI tract (11.0%), and gynecologic (9.0%) cancers were the most common primary malignancies associated with MPE. The median (IQR) LOS was 5.5 (2.7-10.1) days. The inpatient mortality rate was 11.6%. Median (IQR) hospitalization total charges was $42,376 (21,618-84,679). In the multivariate analyses, sex, location of patient’s residence, primary insurer, primary types of malignancies, and presence of comorbidities were independent predictors of inpatient mortality.

CONCLUSIONS: There is a considerable inpatient burden associated with MPE in the United States with potential demographic, geographic and socioeconomic disparities.

CLINICAL IMPLICATIONS: Our national estimates provide strong population based statistics on the clinical and financial burden of MPE not previously available. This information can be of use for clinicians, scientists, administrators and policy makers as well as industry.

DISCLOSURE: The following authors have nothing to disclose: Niloofar Taghizadeh, Marc Fortin, Alain Tremblay

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