LIVIVO - The Search Portal for Life Sciences

zur deutschen Oberfläche wechseln
Advanced search

Search results

Result 1 - 10 of total 127

Search options

  1. Article: A Modified Technique for Applying Closed Incision Negative Pressure Therapy Dressing Following Total Joint Arthroplasty.

    Dowling, Shane / Alton, Timothy B

    Cureus

    2021  Volume 13, Issue 12, Page(s) e20539

    Abstract: Postoperative incisional management subsequent to total joint replacement arthroplasty is of importance to the orthopedic surgical team. The application of closed incision negative pressure therapy (ciNPT) to surgical incisions following replacement ... ...

    Abstract Postoperative incisional management subsequent to total joint replacement arthroplasty is of importance to the orthopedic surgical team. The application of closed incision negative pressure therapy (ciNPT) to surgical incisions following replacement arthroplasty has demonstrated positive outcomes in orthopedics. This paper describes a technique involving the postoperative application of ciNPT over closed incisions originating from joint arthroplasty to facilitate a reduction in the incidence of surgical site complications (SSCs). To address any potential challenges that may be associated with ciNPT application and removal, the ciNPT dressing was applied to the knee incision with approximately 15 degrees of flexion utilizing the total knee bump to allow the knee to rest with flexion at that angle. For posterior hip replacements or revisions, the readily adjustable ciNPT dressing was enlisted for use to cover curvilinear incisions. The adhesive drape over the foam ciNPT dressing would be blocked to ensure that drain placement, if used, would not be incorporated with the hydrocolloid portion of the dressing. In order to properly apply the dressing, it was imperative that the hydrocolloid portion was not subject to any buckling. The dressing was walked over the foam ciNPT dressing to ensure that there was an absence of tension on the dressing. The manufacturer's instructions support dressing use for a maximum of seven days with continuous subatmospheric pressure (-125 mmHg) applied to the closed incision. Applying the adhesive ciNPT drape over the ciNPT foam dressing with a minimal amount of tension is integral to attaining positive outcomes using ciNPT. Employing ciNPT may reduce the risk of delayed incisional healing and SSCs, which may alleviate providers from extra postoperative global visits.
    Language English
    Publishing date 2021-12-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.20539
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  2. Article ; Online: Adverse delivery hospitalisation outcomes in 2020 during the COVID-19 pandemic.

    Wen, Timothy / Logue, Teresa C / Wright, Jason D / D'Alton, Mary / Booker, Whitney A / Friedman, Alexander M

    BJOG : an international journal of obstetrics and gynaecology

    2024  

    Abstract: Objective: To evaluate risk for adverse obstetric outcomes associated with the coronavirus disease 2019 (COVID-19) pandemic period and with COVID-19 diagnoses.: Design: Serial cross-sectional study.: Setting: A national sample of US delivery ... ...

    Abstract Objective: To evaluate risk for adverse obstetric outcomes associated with the coronavirus disease 2019 (COVID-19) pandemic period and with COVID-19 diagnoses.
    Design: Serial cross-sectional study.
    Setting: A national sample of US delivery hospitalisations before (1/2016 to 2/2020) and during the first 10 months of (3/2020 to 12/2020) the COVID-19 pandemic.
    Population: All 2016-2020 US delivery hospitalisations in the National Inpatient Sample.
    Methods: Delivery hospitalisations were identified and stratified into pre-pandemic and pandemic periods and the likelihood of adverse obstetric outcomes was compared using logistic regression models with adjusted odds ratios (aOR) with 95% confidence intervals (CI) as measures of association. Risk for adverse outcomes was also analysed specifically for 2020 deliveries with a COVID-19 diagnosis.
    Main outcome measure: Adverse maternal outcomes including respiratory complications and cardiac morbidity.
    Results: Of an estimated 18.2 million deliveries, 2.9 million occurred during the pandemic. The proportion of delivery hospitalisations with a COVID-19 diagnosis increased from 0.1% in March 2020 to 3.1% in December. Comparing the pandemic period to the pre-pandemic period, there were higher adjusted odds of transfusion (aOR 1.12, 95% CI 1.05-1.19), a respiratory complication composite (aOR 1.37, 95% CI 1.29-1.46), cardiac severe maternal morbidity (aOR 1.30, 95% 1.20-1.39), postpartum haemorrhage (aOR 1.19, 95% CI 1.15-1.24), placental abruption/antepartum haemorrhage (OR 1.04, 95% CI 1.00-1.08), and hypertensive disorders of pregnancy (OR 1.23, 95% CI 1.21-1.26). These associations were similar to unadjusted analysis. Risk for these outcomes during the pandemic period was significantly higher in the presence of a COVID-19 diagnosis.
    Conclusions: In a national estimate of delivery hospitalisations, the odds of cardiac and respiratory outcomes were higher in 2020 compared with 2016-2019. COVID-19 diagnoses were specifically associated with a range of serious complications.
    Language English
    Publishing date 2024-02-20
    Publishing country England
    Document type Journal Article
    ZDB-ID 2000931-8
    ISSN 1471-0528 ; 0306-5456 ; 1470-0328
    ISSN (online) 1471-0528
    ISSN 0306-5456 ; 1470-0328
    DOI 10.1111/1471-0528.17783
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  3. Article ; Online: Mode of Delivery and Obstetric Complications in the Setting of Prior Uterine Surgery.

    Bogardus, Margaret H / Friedman, Alexander M / Arora, Chetna / D'Alton, Mary E / Wen, Timothy

    American journal of perinatology

    2023  

    Abstract: Objective:  This study aimed to evaluate cesarean rates and risk for obstetric complications among deliveries with a history of prior uterine surgery.: Study design:  This serial cross-sectional study analyzed deliveries with and without prior ... ...

    Abstract Objective:  This study aimed to evaluate cesarean rates and risk for obstetric complications among deliveries with a history of prior uterine surgery.
    Study design:  This serial cross-sectional study analyzed deliveries with and without prior uterine surgery in the 2016-2019 Nationwide Inpatient Sample. Unadjusted and adjusted logistic regression models were performed to assess risk of nontransfusion severe maternal morbidity (SMM) and other obstetric complications based on the presence or absence of prior uterine surgery with unadjusted and adjusted odds ratios (aORs) with 95% confidence intervals (CIs) as measures of association. Adjusted models accounted for demographic, hospital, and delivery factors. Demographics and clinical factors among deliveries with and without a prior history of uterine surgery diagnosis were compared with the chi-square test with
    Results:  Of 14.7 million delivery hospitalization identified, 6,910 (4.7 per 10,000) had a history of uterine surgery and 111,710 (0.76%) experienced SMM. Women with prior uterine surgery were more likely to be older, to be of unknown race or ethnicity, and to have private insurance (
    Conclusion:  These findings suggest that current clinical practice results in similar delivery risks among patients with compared with without prior uterine surgery.
    Key points: · Risk for most adverse outcomes is similar among patients with prior uterine surgery.. · Risk for peripartum hysterectomy was higher with prior uterine surgery.. · Risk for SMM was not higher with prior uterine surgery..
    Language English
    Publishing date 2023-12-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 605671-4
    ISSN 1098-8785 ; 0735-1631
    ISSN (online) 1098-8785
    ISSN 0735-1631
    DOI 10.1055/a-2211-1928
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  4. Article ; Online: Infection and Sepsis Trends during United States' Delivery Hospitalizations from 2000 to 2020.

    Liu, Lilly Y / Friedman, Alexander M / Goffman, Dena / Nathan, Lisa / Sheen, Jean-Ju / Reddy, Uma M / D'Alton, Mary E / Wen, Timothy

    American journal of perinatology

    2024  

    Abstract: Objective:  This study aimed to evaluate trends, risk factors, and outcomes associated with infections and sepsis during delivery hospitalizations in the United States.: Study design:  The 2000-2020 National Inpatient Sample was used for this ... ...

    Abstract Objective:  This study aimed to evaluate trends, risk factors, and outcomes associated with infections and sepsis during delivery hospitalizations in the United States.
    Study design:  The 2000-2020 National Inpatient Sample was used for this repeated cross-sectional analysis. Delivery hospitalizations of patients aged 15 to 54 with and without infection and sepsis were identified. Common infection diagnoses during delivery hospitalizations analyzed included (i) pyelonephritis, (ii) pneumonia/influenza, (iii) endometritis, (iv) cholecystitis, (v) chorioamnionitis, and (vi) wound infection. Temporal trends in sepsis and infection during delivery hospitalizations were analyzed. The associations between sepsis and infection and common chronic health conditions including asthma, chronic hypertension, pregestational diabetes, and obesity were analyzed. The associations between clinical, demographic, and hospital characteristics, and infection and sepsis were determined with unadjusted and adjusted logistic regression models with unadjusted odds ratio (OR) and adjusted odds ratios with 95% confidence intervals as measures of association.
    Results:  An estimated 80,158,622 delivery hospitalizations were identified and included in the analysis, of which 2,766,947 (3.5%) had an infection diagnosis and 32,614 had a sepsis diagnosis (4.1 per 10,000). The most common infection diagnosis was chorioamnionitis (2.7% of deliveries) followed by endometritis (0.4%), and wound infections (0.3%). Infection and sepsis were more common in the setting of chronic health conditions. Evaluating trends in individual infection diagnoses, endometritis and wound infection decreased over the study period both for patients with and without chronic conditions, while risk for pyelonephritis and pneumonia/influenza increased. Sepsis increased over the study period for deliveries with and without chronic condition diagnoses. Risks for adverse outcomes including mortality, severe maternal morbidity, the critical care composite, and acute renal failure were all significantly increased in the presence of sepsis and infection.
    Conclusion:  Endometritis and wound infections decreased over the study period while risk for sepsis increased. Infection and sepsis were associated with chronic health conditions and accounted for a significant proportion of adverse obstetric outcomes including severe maternal morbidity.
    Key points: · Sepsis increased over the study period for deliveries with and without chronic condition diagnoses.. · Endometritis and wound infection decreased over the study period.. · Infection and sepsis accounted for a significant proportion of adverse obstetric outcomes..
    Language English
    Publishing date 2024-02-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 605671-4
    ISSN 1098-8785 ; 0735-1631
    ISSN (online) 1098-8785
    ISSN 0735-1631
    DOI 10.1055/s-0044-1780538
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  5. Article ; Online: Deliveries Among Patients With Maternal Hepatitis C Virus Infection in the United States, 2000-2019.

    Arditi, Brittany / Emont, Jordan / Friedman, Alexander M / D'Alton, Mary E / Wen, Timothy

    Obstetrics and gynecology

    2023  Volume 141, Issue 4, Page(s) 828–836

    Abstract: Objective: To assess clinical characteristics, trends, and outcomes associated with the diagnosis of hepatitis C virus (HCV) infection during pregnancy.: Methods: This cross-sectional study analyzed delivery hospitalizations using the National ... ...

    Abstract Objective: To assess clinical characteristics, trends, and outcomes associated with the diagnosis of hepatitis C virus (HCV) infection during pregnancy.
    Methods: This cross-sectional study analyzed delivery hospitalizations using the National Inpatient Sample. Temporal trends in both diagnosis of HCV infection and clinical characteristics associated with HCV infection were analyzed using joinpoint regression to estimate the average annual percent change (AAPC) with 95% CIs. Survey-adjusted logistic regression models were fit to assess the association among HCV infection and preterm delivery, cesarean delivery, and severe maternal morbidity (SMM), adjusting for clinical, medical, and hospital factors with adjusted odds ratios (aORs) as the measure of association.
    Results: An estimated 76.7 million delivery hospitalizations were included, in which 182,904 (0.24%) delivering individuals had a diagnosis of HCV infection. The prevalence of HCV infection diagnosed in pregnancy increased nearly 10-fold over the study period, from 0.05% in 2000 to 0.49% in 2019, representing an AAPC of 12.5% (95% CI 10.4-14.8%). The prevalence of clinical characteristics associated with HCV infection also increased over the study period, including opioid use disorder (from 10 cases/10,000 birth hospitalizations to 71 cases/10,000 birth hospitalizations), nonopioid substance use disorder (from 71 cases/10,000 birth hospitalizations to 217 cases/10,000 birth hospitalizations), mental health conditions (from 219 cases/10,000 birth hospitalizations to 1,117 cases/10,000), and tobacco use (from 61 cases/10,000 birth hospitalizations to 842 cases/10,000). The rate of deliveries among patients with two or more clinical characteristics associated with HCV infection increased from 26 cases per 10,000 birth hospitalizations to 377 cases per 10,000 delivery hospitalizations (AAPC 13.4%, 95% CI 12.1-14.8%). In adjusted analyses, HCV infection was associated with increased risk for SMM (aOR 1.78, 95% CI 1.61-1.96), preterm birth (aOR 1.88, 95% CI 1.8-1.95), and cesarean delivery (aOR 1.27, 95% CI 1.23-1.31).
    Conclusion: Diagnosis of HCV infection is increasingly common in the obstetric population, which may reflect an increase in screening or a true increase in prevalence. The increase in HCV infection diagnoses occurred in the setting of many baseline clinical characteristics that are associated with HCV infection becoming more common.
    MeSH term(s) Pregnancy ; Female ; Humans ; Infant, Newborn ; United States/epidemiology ; Hepacivirus ; Premature Birth/epidemiology ; Cross-Sectional Studies ; Hepatitis C/diagnosis ; Hepatitis C/epidemiology ; Parturition
    Language English
    Publishing date 2023-03-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 207330-4
    ISSN 1873-233X ; 0029-7844
    ISSN (online) 1873-233X
    ISSN 0029-7844
    DOI 10.1097/AOG.0000000000005119
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  6. Article ; Online: Continuation of psychiatric medications during pregnancy.

    Logue, Teresa C / Wen, Timothy / Huang, Yongmei / Wright, Jason D / D'Alton, Mary E / Friedman, Alexander M

    The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians

    2023  Volume 36, Issue 1, Page(s) 2171288

    Abstract: Background: ...

    Abstract Background:
    MeSH term(s) Pregnancy ; Female ; Humans ; United States ; Depression/drug therapy ; Anti-Anxiety Agents/therapeutic use ; Antidepressive Agents/therapeutic use ; Fluoxetine/therapeutic use ; Pharmaceutical Preparations ; Pregnancy Complications/drug therapy ; Pregnancy Complications/chemically induced
    Chemical Substances Anti-Anxiety Agents ; Antidepressive Agents ; Fluoxetine (01K63SUP8D) ; Pharmaceutical Preparations
    Language English
    Publishing date 2023-01-30
    Publishing country England
    Document type Journal Article
    ZDB-ID 2077261-0
    ISSN 1476-4954 ; 1057-0802 ; 1476-7058
    ISSN (online) 1476-4954
    ISSN 1057-0802 ; 1476-7058
    DOI 10.1080/14767058.2023.2171288
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  7. Article ; Online: Trends in Attempted Vaginal Delivery among Pregnancies Complicated by Gastroschisis, 2014 to 2020.

    Schmidt, Christina N / Wen, Timothy / Friedman, Alexander M / D'Alton, Mary E / Andrikopoulou, Maria

    American journal of perinatology

    2022  Volume 41, Issue 5, Page(s) 543–547

    Abstract: Objective:  Gastroschisis is a full-thickness congenital defect of the abdominal wall through which intestines and other organs may herniate. In a prior analysis, attempted vaginal delivery with fetal gastroschisis appeared to increase through 2013, ... ...

    Abstract Objective:  Gastroschisis is a full-thickness congenital defect of the abdominal wall through which intestines and other organs may herniate. In a prior analysis, attempted vaginal delivery with fetal gastroschisis appeared to increase through 2013, although cesarean delivery remained common. The objective of this analysis was to update current trends in attempted vaginal birth among pregnancies complicated by gastroschisis.
    Study design:  We performed an updated cross-sectional analysis of live births from 2014 and 2020 using data from the U.S. National Vital Statistics System and evaluated trends in attempted vaginal deliveries among births with gastroschisis. Trends were evaluated using joinpoint regression. We constructed logistic regression models to evaluate the association between demographic and clinical variables and attempted vaginal delivery in the setting of gastroschisis.
    Results:  Among 5,355 deliveries with gastroschisis meeting inclusion criteria, attempted vaginal delivery increased significantly from 68.9% to 75.1%, an average annual percent change of 1.7% (95% confidence interval [CI], 0.8-2.5). Among gastroschisis-complicated pregnancies, patients 35 to 39 years old (adjusted odds ratio [aOR], 0.53; 95% CI, 0.37-0.79) and Hispanic race/ethnicity (aOR, 0.69; 95% CI, 0.58-0.62) were at lower likelihood of attempted vaginal delivery in adjusted analyses.
    Conclusion:  These findings suggest that vaginal delivery continues to increase in the setting of gastroschisis. Further reduction of surgical delivery for this fetal defect may be possible.
    Key points: · Vaginal deliveries increased among gastroschisis pregnancies.. · Hispanic patients were less likely to attempt vaginal delivery.. · Some gastroschisis pregnancies still deliver surgically..
    MeSH term(s) Pregnancy ; Female ; Humans ; Adult ; Gastroschisis/epidemiology ; Gastroschisis/surgery ; Cross-Sectional Studies ; Delivery, Obstetric ; Cesarean Section
    Language English
    Publishing date 2022-11-30
    Publishing country United States
    Document type Journal Article
    ZDB-ID 605671-4
    ISSN 1098-8785 ; 0735-1631
    ISSN (online) 1098-8785
    ISSN 0735-1631
    DOI 10.1055/a-1990-8668
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  8. Article ; Online: Trends in and outcomes of delivery hospitalizations with lupus and antiphospholipid syndrome.

    Lopez, Ashley / Wen, Timothy / Patel, Naomi / Booker, Whitney A / D'Alton, Mary E / Friedman, Alexander M

    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

    2023  Volume 164, Issue 3, Page(s) 1001–1009

    Abstract: Objective: To assess trends and outcomes associated with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) during US delivery hospitalizations.: Study design: The National Inpatient Sample from 2000 to 2019 was used for this ... ...

    Abstract Objective: To assess trends and outcomes associated with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) during US delivery hospitalizations.
    Study design: The National Inpatient Sample from 2000 to 2019 was used for this repeated cross-sectional analysis. We identified delivery hospitalizations with and without SLE. Temporal trends in SLE during delivery hospitalizations were determined using joinpoint regression. Adjusted logistic regression models accounting for demographic, clinical, and hospital factors were used to determine adjusted odds ratios (aORs) for adverse outcomes based on the presence or absence of SLE.
    Results: Of an estimated 76 698 775 delivery hospitalizations identified in the NIS, 79386 (0.10%) had an associated diagnosis of SLE. Over the study period, SLE increased from 6.7 to 14.6 cases per 10 000 delivery hospitalizations (average annual percent change 4.5%, 95% CI 4.0-5.1). Deliveries with SLE had greater odds of non-transfusion severe morbidity (aOR 2.21, 95% CI 2.00, 2.44) and underwent a larger absolute increase in morbidity risk over the study period. SLE was associated with a range of other adverse outcomes including preterm delivery, eclampsia, cesarean delivery, and blood transfusion.
    Conclusion: The proportion of deliveries to women with SLE has increased over time in the US, and SLE and APS are associated with a broad range of adverse outcomes.
    MeSH term(s) Pregnancy ; Infant, Newborn ; Humans ; Female ; Antiphospholipid Syndrome/epidemiology ; Cross-Sectional Studies ; Lupus Erythematosus, Systemic/epidemiology ; Lupus Erythematosus, Systemic/complications ; Hospitalization ; Eclampsia
    Language English
    Publishing date 2023-10-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80149-5
    ISSN 1879-3479 ; 0020-7292
    ISSN (online) 1879-3479
    ISSN 0020-7292
    DOI 10.1002/ijgo.15171
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  9. Article ; Online: Resource utilization and costs for robotic-assisted and manual total knee arthroplasty - a premier healthcare database study.

    Alton, Timothy B / Chitnis, Abhishek S / Goldstein, Laura / Rajappan, Sidharth Kovilakam / Gupta, Anshu / Michnacs, Kristian / Holy, Chantal E / Hoeffel, Daniel P

    Expert review of medical devices

    2023  Volume 20, Issue 4, Page(s) 303–311

    Abstract: Introduction: The impact of robotic-assisted total knee arthroplasty (rTKA) vs. traditional, manual TKA (mTKA) on hospital costs is not well documented and is analyzed herein.: Research design and methods: Patients in the Premier billing Healthcare ... ...

    Abstract Introduction: The impact of robotic-assisted total knee arthroplasty (rTKA) vs. traditional, manual TKA (mTKA) on hospital costs is not well documented and is analyzed herein.
    Research design and methods: Patients in the Premier billing Healthcare Database undergoing elective rTKA or mTKA ("index') in the in- or outpatient setting for knee osteoarthritis between Oct 1
    Results: 16,714 rTKA patients were matched to 51,199 mTKA patients. Average 90-day hospital cost reached $17,932 and were equivalent for both cohorts (rTKA vs. mTKA: $132 (95% confidence interval; -$19 to $284). There was a 2.7% (95%CI: 2.2%-3.3%) increase in home or home health discharge, and a 0.4% (95%CI: 0%-0.8%) decrease in 90-day hospital knee related re-visit in the rTKA vs. mTKA group.
    Conclusions: Cost-neutrality of rTKA vs. mTKA was observed, with a potential for lowered immediate post-operative HCU in the rTKA vs. mTKA cohorts.
    MeSH term(s) Humans ; Arthroplasty, Replacement, Knee ; Robotic Surgical Procedures ; Patient Acceptance of Health Care ; Hospitals ; Knee Joint
    Language English
    Publishing date 2023-03-02
    Publishing country England
    Document type Journal Article
    ZDB-ID 2250857-0
    ISSN 1745-2422 ; 1743-4440
    ISSN (online) 1745-2422
    ISSN 1743-4440
    DOI 10.1080/17434440.2023.2185135
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  10. Article ; Online: Peripartum cardiomyopathy delivery hospitalization and postpartum readmission trends, risk factors, and outcomes.

    Azad, Hooman / Wen, Timothy / Bello, Natalie A / Booker, Whitney A / Purisch, Stephanie / D'Alton, Mary E / Friedman, Alexander M

    Pregnancy hypertension

    2023  Volume 34, Page(s) 116–123

    Abstract: Objective: To evaluate risk for peripartum cardiomyopathy during delivery and postpartum hospitalizations, and analyze associated trends, risk factors, and clinical outcomes.: Methods: The 2010-2020 Nationwide Readmissions Database was used for this ... ...

    Abstract Objective: To evaluate risk for peripartum cardiomyopathy during delivery and postpartum hospitalizations, and analyze associated trends, risk factors, and clinical outcomes.
    Methods: The 2010-2020 Nationwide Readmissions Database was used for this retrospective cohort study. Delivery hospitalizations along with postpartum readmissions occurring within five months of delivery discharge were analyzed. Risk factors associated with peripartum cardiomyopathy were analyzed with unadjusted and adjusted logistic regression models with odds ratios as measures of effect. Risk for severe adverse outcomes associated with peripartum cardiomyopathy was analyzed. Trends were analyzed with joinpoint regression.
    Results: Of 39,790,772 delivery hospitalizations identified, 9,210 were complicated by a diagnosis of peripartum cardiomyopathy (2.3 per 10,000). Risk for a 5-month readmission with a peripartum cardiomyopathy diagnosis was 4.8 per 10,000. Factors associated with peripartum cardiomyopathy during deliveries included preeclampsia with severe features (OR 18.9, 95 % CI 17.2, 20.7), preeclampsia without severe features (OR 6.9, 95 % CI 6.1, 7.8), multiple gestation (OR 4.7, 95 % CI 4.1, 5.3), chronic hypertension (OR 10.1, 95 % CI 8.9, 11.3), and older maternal age. Associations were attenuated but retained significance in adjusted models. Similar estimates were found when evaluating associations with postpartum readmissions. Peripartum cardiomyopathy readmissions were associated with 10 % of overall postpartum deaths, 21 % of cardiac arrest/ventricular fibrillation diagnoses, 18 % of extracorporeal membrane oxygenation cases, and 40 % of cardiogenic shock. In joinpoint analysis, peripartum cardiomyopathy increased significantly during delivery hospitalizations (average annual percent change [AAPC] 2.2 %, 95 % CI 1.0 %, 3.4 %) but not postpartum readmissions (AAPC 0.0 %, 95 % CI -1.6 %, 1.6 %).
    Conclusion: Risk for peripartum cardiomyopathy increased during delivery hospitalizations over the study period. Obstetric conditions such as preeclampsia and chronic medical conditions that are increasing in prevalence in the obstetric population were associated with the highest odds of peripartum cardiomyopathy.
    MeSH term(s) Pregnancy ; Female ; Humans ; Patient Readmission ; Pre-Eclampsia/epidemiology ; Retrospective Studies ; Peripartum Period ; Hospitalization ; Postpartum Period ; Puerperal Disorders/epidemiology ; Puerperal Disorders/therapy ; Cardiomyopathies/epidemiology ; Cardiomyopathies/therapy ; Risk Factors
    Language English
    Publishing date 2023-11-09
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2584464-7
    ISSN 2210-7797 ; 2210-7789
    ISSN (online) 2210-7797
    ISSN 2210-7789
    DOI 10.1016/j.preghy.2023.11.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

To top