Abstract:
BACKGROUND:Over 2.1 million individuals in the United Stats have cirrhosis, including 513,000 with decompensated cirrhosis. Hospitals with high safety-net burden disproportionately serve ethnic minorities and have reported worse outcomes in surgical literature. No studies to date have evaluated whether hospital safety-net burden negatively affects hospitalization outcomes in cirrhosis. We aim to evaluate the impact of hospitals' safety-net burden and patients' ethnicity on in-hospital mortality among cirrhosis patients. METHODS:Using National Inpatient Sample data from 2012 to 2016, the largest United States all-payer inpatient health care claims database of hospital discharges, cirrhosis-related hospitalizations were stratified into tertiles of safety-net burden: high (HBH), medium (MBH), and low (LBH) burden hospitals. Safety-net burden was calculated as percentage of hospitalizations per hospital with Medicaid or uninsured payer status. Multivariable logistic regression evaluated factors associated with in-hospital mortality. RESULTS:Among 322,944 cirrhosis-related hospitalizations (63.7% white, 9.9% black, 15.6% Hispanic), higher odds of hospitalization in HBHs versus MBH/LBHs was observed in blacks (OR, 1.26; 95%CI, 1.17-1.35; P<0.001) and Hispanics (OR, 1.63; 95% CI, 1.50-1.78; P<0.001) versus whites. Cirrhosis-related hospitalizations in MBHs or HBHs were associated with greater odds of in-hospital mortality versus LBHs (HBH vs. LBH: OR, 1.05; 95% CI, 1.00-1.10; P=0.044). Greater odds of in-hospital mortality was observed in blacks (OR, 1.27; 95% CI, 1.21-1.34; P<0.001) versus whites. CONCLUSION:Cirrhosis patients hospitalized in HBH experienced 5% higher mortality than those in LBH, resulting in significantly greater deaths in cirrhosis patients. Even after adjusting for safety-net burden, blacks with cirrhosis had 27% higher in-hospital mortality compared with whites.
journal_name
J Clin Gastroenteroljournal_title
Journal of clinical gastroenterologyauthors
Wong RJ,Hirode Gdoi
10.1097/MCG.0000000000001452subject
Has Abstractpub_date
2020-10-29 00:00:00eissn
0192-0790issn
1539-2031pub_type
杂志文章abstract::We report a patient in whom cyproheptadine-induced hepatitis was followed by prolonged cholestasis marked by elevation of serum alkaline phosphatase levels, gammaglutamyltransferase and bile acid levels, and disappearance of small bile ducts. Chlorpromazine and imipramine, which can induce a similar acute hepatitis fo...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198702000-00026
更新日期:1987-02-01 00:00:00
abstract::In up to 10% to 20% of colonoscopies, complete intubation of the colon may be considerably difficult. A principal cause of difficulty is looping of the endoscope shaft in a floppy, often tortuous segment of the colon that typically happens in the sigmoid colon. Also, if looping is not recognized and the scope is advan...
journal_title:Journal of clinical gastroenterology
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abstract:BACKGROUND AND AIM:Intestinal fatty acid-binding protein (I-FABP) is a useful marker in the detection of intestinal ischemia. However, more insight into the test characteristics of I-FABP release is needed. This study aimed to investigate the relationship between plasma I-FABP levels and the severity of ischemic mucosa...
journal_title:Journal of clinical gastroenterology
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doi:10.1097/MCG.0b013e3182a87e3e
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abstract:GOAL:The goal of this study was to assess the relationship between pretransplant measures of reflux and longer-term outcomes of chronic allograft rejection in lung transplant recipients. BACKGROUND:Bronchiolitis obliterans syndrome (BOS) is a primary measure of morbidity and mortality following lung transplantation, a...
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journal_title:Journal of clinical gastroenterology
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abstract:OBJECTIVE:To manage hepatocellular carcinoma (HCC) patients surviving for a long term, the treatment strategy for recurrent cancer is as important as that for the initial treatment. However, no prognostic scoring system has been available for patients with HCC recurrence. The purpose of this study was to develop a new ...
journal_title:Journal of clinical gastroenterology
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abstract::One hundred forty-six consecutive specimens of excised bowel from patients with Crohn's disease were studied to determine the relationships between strictures, sinuses, and "fissures." A significant coincidence of sinuses and strictures was observed and sinuses tended to arise proximal to the point of maximal strictur...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198610000-00024
更新日期:1986-10-01 00:00:00
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pub_type: 杂志文章,多中心研究
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journal_title:Journal of clinical gastroenterology
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199206001-00012
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-199210000-00014
更新日期:1992-10-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199209000-00005
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198908000-00013
更新日期:1989-08-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198412000-00009
更新日期:1984-12-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e318157464b
更新日期:2009-01-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000000251
更新日期:2015-10-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199800001-00021
更新日期:1998-01-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199104000-00019
更新日期:1991-04-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198608000-00020
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198508000-00019
更新日期:1985-08-01 00:00:00
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pub_type: 杂志文章,评审
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journal_title:Journal of clinical gastroenterology
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doi:10.1097/00004836-200411000-00014
更新日期:2004-11-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:
更新日期:1994-07-01 00:00:00
abstract::The synthesis of prostaglandin E2 (PGE2) and leukotriene B4 (LTB4) in colonic mucosal cells was investigated in 7 patients and 10 controls. Biopsies obtained from the descending colon were isolated biochemically by a special technique and the suspension of isolated colonic cells was incubated during 45 min. Compared w...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199603000-00009
更新日期:1996-03-01 00:00:00
abstract::Antacids, cimetidine, carbenoxolone, colloidal bismuth, and prostaglandins promote healing of gastric and duodenal ulcer at a rate nearly twice that of healing during placebo administration. These short-term, 4-12 week healing rates are nearly the same for each agent, with a 65 to 85% range. Drugs that appear to produ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:
更新日期:1981-01-01 00:00:00
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journal_title:Journal of clinical gastroenterology
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更新日期:2014-03-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
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更新日期:2002-07-01 00:00:00
abstract::The single technological advancement that Bravo pH monitoring offers over conventional pH monitoring is the elimination of the transnasal catheter. This was not a trivial advance in terms of technologic achievement. Development of a delivery system that could temporarily place a wireless capsule on the esophageal muco...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MCG.0b013e31815bb602
更新日期:2008-05-01 00:00:00
abstract::Meal period exclusion from 24-h pH testing allows better separation between controls and patients with gastroesophageal reflux disease. We reviewed the results of 24-h pH studies of 350 patients with reflux symptoms. They were divided into two groups based on the 95th percentile of the total percentage of time when pH...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199707000-00003
更新日期:1997-07-01 00:00:00