MiscellaneousNational Trends and In-Hospital Outcomes in Pregnant Women With Heart Disease in the United States
Section snippets
Methods
We utilized data from the 2003 to 2012 National Inpatient Sample (NIS), collected by the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project, which is the largest all-payer inpatient publicly available database in the United States.9 NIS provides annual information on approximately 8 million inpatient stays from about 1,000 hospitals, and estimates a 20% stratified sample from a sampling frame that comprises 90% of US acute care hospital admissions. To facilitate
Results
Clinical and demographic characteristics of all women with HD at delivery (n = 81,295) and those without (n = 39,894,032) groups are summarized in Table 1. Compared with women without HD, those patients with HD were more likely to be white, insured by Medicare, have diabetes mellitus and multiple gestation, and undergo deliveries in an urban-teaching hospital located in the northeast or midwest (p <0.05 for all). Patients with HD had a higher prevalence of transient hypertension, pre-eclampsia
Discussion
The annual number of hospitalizations for delivery in women with HD in the United States, particularly cardiomyopathy, CHD, and PH, has significantly increased, with a significant and gradual increase in MACEs. The cardiomyopathy cohort had the highest rates of MACEs, highest total hospital charges, and longest length of stay, while CHD had the lowest PH and cardiomyopathy patients demonstrated the highest in-hospital mortality.
The NIS was used to illustrate national trends in HD and its
Acknowledgment
We acknowledge the statistical support provided by the Biostatistical Consulting Core at the Stony Brook School of Medicine, Stony Brook, New York.
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2022, American Journal of Obstetrics and GynecologyCitation Excerpt :Our analysis included a number of observational studies based on large administrative databases that rely on diagnosis and billing codes for the identification of study populations.4,30,32,34,35 Such studies carry inherent limitations because of the possibility of coding errors, including ascertainment bias, although previous work suggests that this error rate may be low.35 These studies also lack detailed echocardiographic data, for example, left ventricular ejection fraction, which would be useful to aid further risk stratification.
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