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Kilani Y, Aljabiri Y, Arshad I, Alsakarneh S, Aldiabat M, Castro Puello P, Vahanyan A, Vikash F, Kumar V, Numan L, Thor S. Cannabis use and cyclical vomiting syndrome: An open debate. Dig Liver Dis 2024; 56:272-280. [PMID: 37880016 DOI: 10.1016/j.dld.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/06/2023] [Accepted: 10/01/2023] [Indexed: 10/27/2023]
Abstract
INTRODUCTION Cyclical vomiting syndrome (CVS) carries a significant financial burden on the U.S. healthcare system due to the recurrent emergency department visits and inpatient hospitalizations. We aimed to update the literature on the predictors of hospital utilization and readmission among individuals admitted with CVS. METHODS This is a retrospective nationwide study of patients hospitalized with a primary diagnosis of CVS. Using weighted data from the National Inpatient Sample (NIS) and the National Readmission Database (NRD), we conducted a multivariate regression analysis to assess predictors of length of stay (LOS), and 30-day readmission. RESULTS Primary admissions for CVS totaled 35,055 in the NIS, and 31,240 in the NRD. 2012 patients (6.4%) were readmitted within 30 days. On multivariate regression, cannabis use was associated with reduced LOS (adjusted Mean Difference (aMD) = -0.53 days, 95% CI: -0.68 to -0.38), and 30-day readmissions (adjusted Hazard Ratio (aHR) = 0.63, 95% CI: 0.54-0.73). DISCUSSION Cannabis use among CVS admissions was associated with reduced LOS and 30-day readmissions; these results could be in fact driven by Cannabis Hyperemesis Syndrome (CHS)-related hospitalizations and the effect of cannabis cessation on decreased symptomatology. ICD-10 coding for CHS should be transitioned to specific codes to improve the differentiation between CVS and CHS-related hospitalizations.
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Affiliation(s)
- Yassine Kilani
- Department of Medicine, Lincoln Medical Center/Weill Cornell Medical College, New York, USA.
| | - Yazan Aljabiri
- Department of Medicine, Washington University in St. Louis, Saint Louis, USA
| | - Iqra Arshad
- Department of Medicine, Saint Louis University School of Medicine, Saint Louis, USA
| | - Saqr Alsakarneh
- Department of Medicine, University of Missouri-Kansas City, Kansas City, USA
| | - Mohammad Aldiabat
- Department of Medicine, Washington University in St. Louis, Saint Louis, USA
| | - Priscila Castro Puello
- Department of Medicine, Lincoln Medical Center/Weill Cornell Medical College, New York, USA
| | - Anush Vahanyan
- Department of Medicine, Lincoln Medical Center/Weill Cornell Medical College, New York, USA
| | - Fnu Vikash
- Department of Medicine, Jacobi Medical Center, New York, NY
| | - Vikash Kumar
- Department of Medicine, Brooklyn Hospital Center, New York, USA
| | - Laith Numan
- Department of Gastroenterology & Hepatology, Saint Louis University, Saint Louis, USA
| | - Savanna Thor
- Division of Gastroenterology & Hepatology, SUNY Downstate Health Sciences University, New York, USA
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Kilani Y, Kamal SAF, Vikash F, Vikash S, Aldiabat M, Alsakarneh S, Aljabiri Y, Sohail H, Kumar V, Numan L, Al Khalloufi K. Correction to: Racial Disparities in Liver Transplantation for Hepatocellular Carcinoma in the United States: An Update. Dig Dis Sci 2023; 68:4538-4539. [PMID: 37831400 DOI: 10.1007/s10620-023-08131-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Affiliation(s)
- Yassine Kilani
- Department of Medicine, Medical Center/Weill Cornell Medicine, New York, NY, USA.
| | | | - Fnu Vikash
- Department of Medicine, Jacobi Medical Center, New York, NY, USA
| | - Sindhu Vikash
- Department of Medicine, Jacobi Medical Center, New York, NY, USA
| | | | - Saqr Alsakarneh
- Department of Medicine, University of Missouri, Kansas City, MO, USA
| | - Yazan Aljabiri
- Department of Medicine, Medical Center/Weill Cornell Medicine, New York, NY, USA
| | - Haris Sohail
- Department of Medicine, Medical Center/Weill Cornell Medicine, New York, NY, USA
| | - Vikash Kumar
- Department of Medicine, Brooklyn Hospital Center, New York, NY, USA
| | - Laith Numan
- Department of Gastroenterology, Saint Louis University, Saint Louis, MO, USA
| | - Kawtar Al Khalloufi
- Department of Transplant Hepatology, University of South Florida, Tampa, FL, USA
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Aldiabat M, Kilani Y, Arshad I, Rana T, Aleyadeh W, Al Ta'ani O, Aljabiri Y, Alsakarneh S, Abdelfattah T, Alhuneafat L, Manvar A. Determinants and outcomes of acute pancreatitis in patients hospitalized for COVID-19: Early pandemic experience. Pancreatology 2023; 23:926-934. [PMID: 37865613 DOI: 10.1016/j.pan.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/09/2023] [Accepted: 10/14/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVES To examine the predictors and outcomes associated with the development of acute pancreatitis (AP) in patients hospitalized with Coronavirus Disease 2019 (COVID-19). METHODS This is an observational analysis of the 2020 National Inpatient Sample Database. The study includes adult patients who were admitted with a confirmed diagnosis of COVID-19 and stratifies them based on the presence or absence of AP during their hospitalization. Predictors of AP development between the two groups and differences in outcomes are examined. Multivariate logistic regression analysis using Stata/BE 17.0 is conducted, with adjustments made for age, sex, race, and Charlson Comorbidity Index (CCI). Statistical significance is determined at a p-value of <0.05. RESULTS Significant factors associated with an increased risk of AP in COVID-19 patients include Hispanic ethnicity, higher Charlson Comorbidity Index (CCI) score, residence in states located in the southern region, history of chronic kidney disease, chronic liver disease, malnutrition, portal hypertension, and alcohol use. COVID-19 patients who developed AP were also found to be at higher risk of adverse outcomes, including mortality, acute coronary syndrome, acute kidney injury, sepsis, septic shock, in-hospital cardiac arrest, invasive mechanical ventilation, upper gastrointestinal bleeding, prolonged length of stay, and increased healthcare cost. CONCLUSIONS In hospitalized patients with COVID-19, the presence of AP is associated with increased mortality and morbidity. Risk factors for developing AP in this population include Hispanic ethnicity, residence in the southern region, higher Charlson Comorbidity Index (CCI) score, history of chronic kidney disease, chronic liver disease, malnutrition, portal hypertension, and alcohol use.
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Affiliation(s)
- Mohammad Aldiabat
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
| | - Yassine Kilani
- Department of Medicine, Lincoln Medical Center/Weil Cornell Medicine, Bronx, NY, USA.
| | - Iqra Arshad
- Department of Medicine, Lincoln Medical Center/Weil Cornell Medicine, Bronx, NY, USA.
| | - Tabeer Rana
- Department of Medicine, Allegheny Health Network, Pittsburgh, PA, USA.
| | - Wesam Aleyadeh
- Department of Medicine, Cleveland Clinic Akron General, Akron, OH, USA.
| | - Omar Al Ta'ani
- Department of Medicine, Allegheny Health Network, Pittsburgh, PA, USA.
| | - Yazan Aljabiri
- Department of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA.
| | - Saqr Alsakarneh
- Department of Medicine, University of Missouri-Kansas City, Kansas City, MO, 64108, USA.
| | - Thaer Abdelfattah
- Department of Medicine, Allegheny Health Network, Pittsburgh, PA, USA.
| | - Laith Alhuneafat
- Department of Medicine, Allegheny Health Network, Pittsburgh, PA, USA.
| | - Amar Manvar
- Division of Gastroenterology, NYU Langone Health, Mineola, NY, USA.
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Aldiabat M, Kilani Y, Alahmad M, Alhuneafat L, Aljabiri Y, Horoub A, Alabdallah K, Alrahamneh H, Manvar A. Inpatient Outcomes of Gastric Antral Vascular Ectasia in Those With Aortic Stenosis: A Retrospective Study of 85,000 Hospitalizations. J Clin Gastroenterol 2023:00004836-990000000-00220. [PMID: 37994146 DOI: 10.1097/mcg.0000000000001932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 08/31/2023] [Indexed: 11/24/2023]
Abstract
GOALS To investigate the outcomes of hospitalized patients with gastric antral vascular ectasia (GAVE) in the setting of aortic stenosis (AS). BACKGROUND Although AS is associated with gastrointestinal arteriovenous malformations, its association with GAVE, a rare cause of upper gastrointestinal bleeding, remains unknown. STUDY The National Inpatient Sample database from the years 2016 to 2019 was searched for patients admitted with a diagnosis of GAVE, with and without a history of AS. Univariate and multivariate logistic regression analysis was performed to determine the risk of mortality and in-hospital complications in the GAVE/AS group compared with the GAVE-only group. RESULTS Patients with AS had a 2-fold increase in the risk of GAVE [odds ratio (OR): 2.08, P < 0.001], with no statistically significant difference in inpatient mortality between the study groups (OR: 1.36, P = 0.268). Patients with GAVE-AS had a higher risk of hypovolemic shock (OR: 2.00, P = 0.001) and acute coronary syndromes (OR: 2.25, P < 0.001) with no difference in risk of cardiogenic shock (P = 0.695), acute kidney injury (P = 0.550), blood transfusion (P = 0.270), sepsis (P = 0.598), respiratory failure (P = 0.200), or in-hospital cardiac arrest (P = 0.638). The cost of care in patients with GAVE-AS was increased by a mean of $4729 (P = 0.022), with no increase in length of stay (P = 0.320) when compared with patients with GAVE-only. CONCLUSIONS Patients with AS have a 2-fold increase in the risk of development of GAVE. Patients with AS admitted for GAVE-related bleeding are at higher rates of hypovolemic shock, acute coronary syndrome, and higher resource utilization when compared with admitted patients with GAVE without AS.
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Affiliation(s)
- Mohammad Aldiabat
- Department of Medicine, Washington University in St. Louis, St. Louis
| | - Yassine Kilani
- Department of Medicine, Lincoln Medical Center/Weil Cornell Medicine
| | - Majd Alahmad
- Department of Medicine, University of Missouri-Columbia, Columbia, MO
| | - Laith Alhuneafat
- Department of Cardiovascular Medicine, University of Minnesota, Minneapolis, MN
| | - Yazan Aljabiri
- Department of Medicine, Washington University in St. Louis, St. Louis
| | - Ali Horoub
- Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx
| | - Khaled Alabdallah
- Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA
| | - Hebah Alrahamneh
- Department of Medicine, Mountainview Regional Medical Center, Las Cruces, NM
| | - Amar Manvar
- Division of Gastroenterology, Department of Medicine, NYU Langone Health, Mineola, NY
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Kilani Y, Kamal SAF, Vikash F, Vikash S, Aldiabat M, Alsakarneh S, Aljabiri Y, Sohail H, Kumar V, Numan L, Al Khalloufi K. Racial Disparities in Liver Transplantation for Hepatocellular Carcinoma in the United States: An Update. Dig Dis Sci 2023; 68:4050-4059. [PMID: 37584869 DOI: 10.1007/s10620-023-08084-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 08/07/2023] [Indexed: 08/17/2023]
Abstract
BACKGROUND Previous studies have demonstrated a disparity in liver transplantation (LT) for hepatocellular carcinoma (HCC) among races in the United States (U.S.). AIMS We aimed to update the literature on the odds, trends, and complications of LT in the treatment of hepatocellular carcinoma (HCC), among individuals of different racial backgrounds. METHODS This is a nationwide study of adult individuals admitted for LT with a primary diagnosis of HCC. Using weighted data from the National Inpatient Sample (NIS) database, we compared the odds of LT among different races from 2016 to 2020, using a multivariate regression analysis. We further assessed the trends and outcomes of LT among races. RESULTS A total of 112,110 adult were hospitalized with a primary diagnosis of HCC. 3020 underwent LT. When compared to Whites, the likelihood of undergoing LT for HCC was significantly reduced in Blacks (OR = 0.60, 95% CI = 0.46-0.78). Further, Blacks had increased mortality rates (7% in Blacks vs. 1% in Whites, p < 0.001), sepsis (11% in Blacks vs. 3% in Whites, p = 0.015), and acute kidney injury (AKI) (54% in Blacks vs. 31% in Whites, p < 0.001) following LT. CONCLUSIONS Individuals identifying as Blacks were less likely to undergo LT for HCC, and more likely to develop complications. Further initiatives are warranted to mitigate the existing disparities among racial groups.
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Affiliation(s)
- Yassine Kilani
- Department of Medicine, Lincoln Medical Center/Weill Cornell Medicine, New York, NY, USA.
| | | | - Fnu Vikash
- Department of Medicine, Jacobi Medical Center, New York, NY, USA
| | - Sindhu Vikash
- Department of Medicine, Jacobi Medical Center, New York, NY, USA
| | | | - Saqr Alsakarneh
- Department of Medicine, University of Missouri, Kansas City, MO, USA
| | - Yazan Aljabiri
- Department of Medicine, Lincoln Medical Center/Weill Cornell Medicine, New York, NY, USA
| | - Haris Sohail
- Department of Medicine, Lincoln Medical Center/Weill Cornell Medicine, New York, NY, USA
| | - Vikash Kumar
- Department of Medicine, Brooklyn Hospital Center, New York, NY, USA
| | - Laith Numan
- Department of Gastroenterology, Saint Louis University, Saint Louis, MO, USA
| | - Kawtar Al Khalloufi
- Department of Transplant Hepatology, University of South Florida, Tampa, FL, USA
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Aldiabat M, Aljabiri Y, Kilani Y, Yusuf MH, Al-Khateeb MH, Horoub A, Farukhuddin F, Mahfouz R, Obeidat AE. The Impact of Inflammatory Bowel Disease on Mortality and Other Outcomes of Hospitalized Patients With Diabetic Ketoacidosis: An Observational Study of the United States National Inpatient Sample. Cureus 2022; 14:e28697. [PMID: 36204033 PMCID: PMC9527063 DOI: 10.7759/cureus.28697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2022] [Indexed: 11/19/2022] Open
Abstract
Background Recent studies have shown an increased risk of diabetes mellitus in patients with Inflammatory bowel disease. However, the impact of IBD on outcomes of patients with diabetic ketoacidosis remains unknown. Methods This is an observational analysis of the National Inpatient Sample Database. The authors identified patients with a diagnosis of diabetic ketoacidosis and inflammatory bowel diseases. Outcomes studied were differences in risk of mortality, in-hospital outcomes and healthcare resources utilization. Multivariate logistic analysis was performed and results were adjusted for patient and hospital characteristics and comorbidities. Results No significant difference in mortality was observed in the DKA-IBD group when compared to the DKA-only group (aOR 0.55, p = 0.560). Similarly, inflammatory bowel disease had no impact on risk of sepsis (aOR 1.06, p = 0.742), acute kidney injury (aOR 1.08, p = 0.389), acute coronary syndrome (aOR 0.70, p = 0.397), ischemic stroke (aOR 1.53, p = 0.094), acute respiratory failure (aOR 1.00, p = 0.987), invasive mechanical ventilation (aOR 0.54, p = 0.225), deep vein thrombosis (aOR 1.68, p = 0.275), pulmonary embolism (aOR 2.16, p = 0.279) or cardiac arrest (aOR 1.35, p = 0.672) in diabetic ketoacidosis patients. The study group had a significant increase in length of stay (adjusted mean difference 0.63, p = 0.002) and charge of care (adjusted mean difference 3,950$, p = 0.026). Conclusion Inflammatory bowel disease is not associated with risk difference in mortality or morbidity in admitted patients with diabetic ketoacidosis, however, it does contribute to increased healthcare resources utilization.
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Mahfouz R, Douglas MF, Obeidat AE, Darweesh M, Mansour MM, Shah P, Aldiabat M, Aljabiri Y, Fishman A. Impact of Atrial Fibrillation on Patients With Inflammatory Bowel Disease Admitted for Colectomy. Cureus 2022; 14:e27849. [PMID: 36110442 PMCID: PMC9462059 DOI: 10.7759/cureus.27849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2022] [Indexed: 11/05/2022] Open
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Aldiabat M, Aljabiri Y, Al-Khateeb MH, Yusuf MH, Kilani Y, Horoub A, Farukhuddin F, Mahfouz R, Obeidat AE, Darweesh M, Mansour MM. Effect of Hospital Teaching Status on Mortality and Procedural Complications of Percutaneous Paracentesis in the United States: A Four-Year Analysis of the National Inpatient Sample. Cureus 2022; 14:e26282. [PMID: 35911339 PMCID: PMC9313107 DOI: 10.7759/cureus.26282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2022] [Indexed: 11/19/2022] Open
Abstract
Objectives Numerous previous studies investigated the impact of medical training settings on outcomes of hospitalized patients. However, the impact of teaching hospital status on outcomes of percutaneous paracentesis, to the best of our knowledge, has never been studied before. Methods Hospitalized patients who underwent percutaneous paracentesis were identified from the National Inpatient Sample database from 2016 to 2019 across the United States (US) teaching and non-teaching hospitals. Outcomes studied were differences in risk of mortality, postprocedural outcomes, and healthcare resource utilization. Multivariate logistic analysis was performed using STATA software (StataCorp LLC, College Station, Texas, US) and results were adjusted for patient and hospital characteristics and comorbidities. Results Inpatient mortality rates were significantly higher in patients undergoing paracentesis at US teaching hospitals (adjusted odds ratio (aOR) 1.29, 95%CI 1.23-1.35, p<0.001) compared to non-teaching hospitals. Similarly, higher risk of procedural complications including hemoperitoneum (aOR 1.90, 95%CI 1.65-2.20, p<0.001), hollow viscus perforation (aOR 1.97, 95%CI 1.54-2.51, p<0.001), and vessel injury/laceration (aOR 15.3, 95%CI 2.12-110.2, p=0.007) were noticed in the study group when compared to controls. Furthermore, hospital teaching status was associated with prolonged mean length of stay (9.33 days vs 7.42 days, adjusted mean difference (aMD) 1.81, 95%CI 1.68-1.94, p<0.001) and increased charge of care ($106,014 vs $80,493, aMD $24,926, 95%CI $21,617-$28,235, p <0.001) Conclusion Hospitalized patients undergoing paracentesis in US teaching hospitals have an increased risk of mortality, postprocedural complications, prolonged length of stay, and increased charge of care when compared to non-teaching hospitals.
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El Alayli A, Brignardello Petersen R, Husainat NM, Kalot MA, Aljabiri Y, Turkmani H, Britt A, El-Khechen H, Shahid S, Roller J, Motaghi S, Mansour R, Tosetto A, Abdul-Kadir R, Laffan M, Weyand A, Leebeek FWG, Arapshian A, Kouides P, James P, Connell NT, Flood VH, Mustafa RA. Outcomes of long-term von Willebrand factor prophylaxis use in von Willebrand disease: A systematic literature review. Haemophilia 2022; 28:373-387. [PMID: 35339117 DOI: 10.1111/hae.14550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 01/10/2022] [Accepted: 03/03/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Von Willebrand Disease (VWD) is a common inherited bleeding disorder. Patients with VWD suffering from severe bleeding may benefit from the use of secondary long-term prophylaxis. AIM Systematically summarize the evidence on the clinical outcomes of secondary long-term prophylaxis in patients with VWD and severe recurrent bleedings. METHODS We searched Medline and EMBASE through October 2019 for relevant randomized clinical trials (RCTs) and comparative observational studies (OS) assessing the effects of secondary long-term prophylaxis in patients with VWD. We used Cochrane Risk of Bias (RoB) tool and the RoB for Non-Randomized Studies of interventions (ROBINS-I) tool to assess the quality of the included studies. We conducted random-effects meta-analyses and assessed the certainty of the evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. RESULTS We included 12 studies. Evidence from one placebo controlled RCT suggested that VWD prophylaxis as compared to no prophylaxis reduced the rate of bleeding episodes (Rate ratio [RR], .24; 95% confidence interval [CI], .17-.35; low certainty evidence), and of epistaxis (RR, .38; 95%CI, .21-.67; moderate certainty evidence), and may increase serious adverse events RR 2.73 (95%CI .12-59.57; low certainty). Evidence from four before-and-after studies in which researchers reported comparative data suggested that VWD prophylaxis reduced the rate of bleeding (RR .34; 95%CI, .25-.46; very low certainty evidence). CONCLUSION VWD prophylaxis treatment seems to reduce the risk of spontaneous bleeding, epistaxis, and hospitalizations. More RCTs should be conducted to increase the certainty in these benefits.
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Affiliation(s)
- Abdallah El Alayli
- Outcomes and Implementation Research Unit, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | | | - Nedaa M Husainat
- Department of Internal Medicine, St. Mary's Hospital, Saint Louis, Missouri, USA
| | - Mohamad A Kalot
- The State University of New York at Buffalo Department of Internal Medicine, Buffalo, New York, USA
| | - Yazan Aljabiri
- Lincoln Medical and Mental Health Center, The Bronx, New York, USA
| | - Hani Turkmani
- Department of Cardiovascular Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Alec Britt
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Hussein El-Khechen
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Shaneela Shahid
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - John Roller
- Department of Hematology/Oncology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Shahrzad Motaghi
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Razan Mansour
- Outcomes and Implementation Research Unit, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Alberto Tosetto
- Hemophilia and Thrombosis Center, Hematology Department, S. Bortolo Hospital, Vicenza, Italy
| | - Rezan Abdul-Kadir
- The Royal Free NHS Foundation Hospital and Institute for Women's Health, University College London, London, UK
| | - Michael Laffan
- Centre for Haematology, Imperial College London, London, UK
| | - Angela Weyand
- Division of Pediatric Hematology Oncology, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Frank W G Leebeek
- Department of Hematology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Peter Kouides
- Mary M. Gooley Hemophilia Treatment Center, University of Rochester, Rochester, New York, USA
| | - Paula James
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Nathan T Connell
- Hematology Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Veronica H Flood
- Department of Pediatrics, Medical College of Wisconsin, Versiti Blood Research Institute, Milwaukee, Wisconsin, USA
| | - Reem A Mustafa
- Division of Nephrology and Hypertension, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
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Mahfouz R, Barchuk A, Obeidat AE, Mansour MM, Hernandez D, Darweesh M, Aldiabat M, Al-Khateeb MH, Yusuf MH, Aljabiri Y. The Relationship Between Obstructive Sleep Apnea (OSA) and Gastroesophageal Reflux Disease (GERD) in Inpatient Settings: A Nationwide Study. Cureus 2022; 14:e22810. [PMID: 35399477 PMCID: PMC8980249 DOI: 10.7759/cureus.22810] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction: Several studies identified a link between gastroesophageal reflux disease (GERD) and obstructive sleep apnea (OSA). GERD is a condition in which acid reflux from the stomach to the esophagus causes troublesome symptoms. On the other hand, OSA is defined as a sleep-related breathing disorder in which airflow significantly decreases or ceases due to upper airway obstruction, leading to arousal from sleep. OSA was found to be associated with GERD. In this study, we aim to study the characteristics and concurrent risk factors associated with GERD and OSA in a large population-based study. Methods: Patients with the diagnosis of GERD were extracted from the National Inpatient Database (NIS) for the years 2016 to 2019. Patients' age, gender, race, and hospital information, including region and bed size, were extracted and considered as baseline characteristics. The comorbidities included are hypertension (HTN), atrial fibrillation (AFib), congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), pulmonary hypertension (PHTN), obesity, and smoking. Patients younger than 18 years old were excluded from this study. Results: Out of 22,677,620 patients with the diagnosis of GERD, 12.21% had a concurrent diagnosis of OSA (compared to 4.79% in patients without GERD, p-value <0.001). The mean age of patients with GERD and OSA was 64.47 years vs 65.42 years in patients without OSA (p-value <0.001). The GERD and OSA group had almost identical gender distribution compared to the GERD only group, as it was predominantly female patients. The white and black races were slightly more prevalent in the GERD and OSA group compared to the GERD only group. Regarding comorbidities, the prevalence of obesity was more clear in the GERD and OSA group. It was noted that the group of patients who carry a diagnosis of GERD and OSA have more prevalence of diabetes (DM), hypertension (HTN), obesity, atrial fibrillation (Afib), congestive heart failure (CHF), and pulmonary hypertension (PHTN). Patients with GERD and OSA were 21% less likely to be older than 65 years rather than younger (95% CI: 0.79-0.8, p-value <0.001), 35% less likely to be females (95% CI: 0.65-0.65, p-value <0.001), and 22% less likely to be non-white (95% CI: 0.77-0.8, p-value <0.001). Obesity was found to be the strongest association with this population, followed by PHTN, CHF, DM, HTN, Afib, and lastly smoking. Conclusion: Patients with GERD and OSA were found more likely to be female, white, living in the southern part of the United States, obese, diabetes mellitus type 2, and being active smokers.
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Affiliation(s)
- Ratib Mahfouz
- Internal Medicine, Kent Hospital/Brown University, Warwick, USA
| | | | | | - Mahmoud M Mansour
- Internal Medicine, University of Missouri School of Medicine, Columbia, USA
| | | | - Mohammad Darweesh
- Internal Medicine, East Tennessee State University, Johnson City, USA
| | - Mohammad Aldiabat
- Internal Medicine, New York City Health and Hospitals Corporation (NYCHHC) Lincoln Medical Center, New York, USA
| | - Mohannad H Al-Khateeb
- Internal Medicine, New York City Health and Hospitals Corporation (NYCHHC) Lincoln Medical Center, New York, USA
| | - Mubarak H Yusuf
- Internal Medicine, New York City Health and Hospitals Corporation (NYCHHC) Lincoln Medical Center, New York, USA
| | - Yazan Aljabiri
- Internal Medicine, New York City Health and Hospitals Corporation (NYCHHC) Lincoln Medical Center, New York, USA
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