Comorbidities Predict Length of Stay Among Patients Admitted with Peripheral Artery Disease– An Analysis of The National Inpatient Sample.

Authors' Affiliations

Valentine C. Nriagu, The Center for Cardiovascular Risk Research, College of Public Health, East Tennessee State University, Johnson City, TN 37614; Department of Epidemiology and Biostatistics, College of Public Health, East Tennessee State University, Johnson City, TN 37614 Eugene N. Annor, Department of Environmental Health, College of Public Health, East Tennessee State University, Johnson City, TN 37614 Aamir-Ali Shaikh, Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614 Hadii M. Mamudu, Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN 37614; The Center for Cardiovascular Risk Research, College of Public Health, East Tennessee State University, Johnson City, TN 37614 Florence Weierbach, College of Nursing, East Tennessee State University, Johnson City, TN 37614 Ghaith H. Husari, Computer Science Department, College of Business and Technology, East Tennessee State University, Johnson City, TN 37614 Cori Grant, University of Tennessee Health Science Center Timir Paul, University of Tennessee Health Sciences Center-Nashville

Location

Culp Center Ballroom

Start Date

4-25-2023 9:00 AM

End Date

4-25-2023 11:00 AM

Poster Number

50

Faculty Sponsor’s Department

Health Services Management & Policy

Name of Project's Faculty Sponsor

Hadii Mamudu

Classification of First Author

Graduate Student-Master’s

Competition Type

Competitive

Type

Poster Presentation

Project's Category

Medicine, Cardiovascular Disease, Public Health

Abstract or Artist's Statement

The global prevalence of peripheral artery disease (PAD) is estimated to be about 120 million, making up about 25.6% of the worldwide burden of cardiovascular diseases (CVD). In the United States (U.S.), the prevalence of PAD is about 7%, representing nearly 8 million adults. There is a higher prevalence of disease in Blacks and non-Hispanic Whites, with approximately 30% of Blacks and 20% of non-Hispanic Whites developing PAD in their lifetime. The strong risk factors associated with PAD include smoking, diabetes, hypertension, age, and male sex. Our study aimed to estimate the effects of obesity, alcohol abuse, renal failure, and hypertension on patients’ length of stay (LOS) among patients admitted with a diagnosis of PAD. Using the 2012 U.S. National Inpatient Sample database, we included 336,790 patients with PAD as a separate comorbidity during their index admission. Our main outcome variable was patients’ total length of stay (LOS) during the index admission. We categorized LOS < 1 into next day discharge (NDD) and LOS > 1 into non-NDD. Our predictor variables were hypertension, obesity, alcohol abuse and renal failure. We ran descriptive statistics to delineate the baseline characteristics of our sample population, and bivariate analysis with t-test and chi-square analysis. Multivariable logistic regression was used to estimate odds of non-NDD given our comorbidities; obesity, hypertension, alcohol abuse, renal failure while adjusting for age, race, and sex. We reported frequencies, p-values, and odd ratios (ORs) at a 95% significance level with alpha at 0.05. Of our final sample, 54.8% were males while 45.2% were females and the mean age of patients was 71.7 + 12.8. Hypertension, obesity, alcohol abuse and renal failure were present in 75%, 12%, 3.4%, and 30.9% of patients, respectively. Majority (75%) of the patients were white, while Black and Hispanic patients made up 13.3% and 7.1%, respectively. In our adjusted model, we found that patients with hypertension had 12% lower odds of non-NDD (OR = 0.88, CI= 0.86-0.90, P<0.0001) compared to those without hypertension, females had 20% increase in the odds of non-NDD compared to males (OR = 1.20, CI= 1.18-1.23, P<0.0001), patients with obesity, alcohol abuse and renal failure had 39%, 43% and 45% increase in odds of non-NDD compared to those without these comorbidities. (OR = 1.39, CI= 1.34-1.44, P<0.0001), (OR = 1.43, CI= 1.35-1.52, P<0.0001), (OR = 1.45, CI= 1.42-1.49, P<0.0001). Given the significant association between obesity, alcohol abuse, and renal failure with prolonged hospital stay in patients admitted to hospital with PAD, our study highlights the importance of adequate management of pre-existing patients' comorbidities. This is expected to improve overall length of stay and total healthcare utilization and costs, among patients with PAD.

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Apr 25th, 9:00 AM Apr 25th, 11:00 AM

Comorbidities Predict Length of Stay Among Patients Admitted with Peripheral Artery Disease– An Analysis of The National Inpatient Sample.

Culp Center Ballroom

The global prevalence of peripheral artery disease (PAD) is estimated to be about 120 million, making up about 25.6% of the worldwide burden of cardiovascular diseases (CVD). In the United States (U.S.), the prevalence of PAD is about 7%, representing nearly 8 million adults. There is a higher prevalence of disease in Blacks and non-Hispanic Whites, with approximately 30% of Blacks and 20% of non-Hispanic Whites developing PAD in their lifetime. The strong risk factors associated with PAD include smoking, diabetes, hypertension, age, and male sex. Our study aimed to estimate the effects of obesity, alcohol abuse, renal failure, and hypertension on patients’ length of stay (LOS) among patients admitted with a diagnosis of PAD. Using the 2012 U.S. National Inpatient Sample database, we included 336,790 patients with PAD as a separate comorbidity during their index admission. Our main outcome variable was patients’ total length of stay (LOS) during the index admission. We categorized LOS < 1 into next day discharge (NDD) and LOS > 1 into non-NDD. Our predictor variables were hypertension, obesity, alcohol abuse and renal failure. We ran descriptive statistics to delineate the baseline characteristics of our sample population, and bivariate analysis with t-test and chi-square analysis. Multivariable logistic regression was used to estimate odds of non-NDD given our comorbidities; obesity, hypertension, alcohol abuse, renal failure while adjusting for age, race, and sex. We reported frequencies, p-values, and odd ratios (ORs) at a 95% significance level with alpha at 0.05. Of our final sample, 54.8% were males while 45.2% were females and the mean age of patients was 71.7 + 12.8. Hypertension, obesity, alcohol abuse and renal failure were present in 75%, 12%, 3.4%, and 30.9% of patients, respectively. Majority (75%) of the patients were white, while Black and Hispanic patients made up 13.3% and 7.1%, respectively. In our adjusted model, we found that patients with hypertension had 12% lower odds of non-NDD (OR = 0.88, CI= 0.86-0.90, P<0.0001) compared to those without hypertension, females had 20% increase in the odds of non-NDD compared to males (OR = 1.20, CI= 1.18-1.23, P<0.0001), patients with obesity, alcohol abuse and renal failure had 39%, 43% and 45% increase in odds of non-NDD compared to those without these comorbidities. (OR = 1.39, CI= 1.34-1.44, P<0.0001), (OR = 1.43, CI= 1.35-1.52, P<0.0001), (OR = 1.45, CI= 1.42-1.49, P<0.0001). Given the significant association between obesity, alcohol abuse, and renal failure with prolonged hospital stay in patients admitted to hospital with PAD, our study highlights the importance of adequate management of pre-existing patients' comorbidities. This is expected to improve overall length of stay and total healthcare utilization and costs, among patients with PAD.