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Article ; Online: Respiratory Infections.

Detelich, Joshua F / Kempker, Jordan A

2023 Volume 44, Issue 3, Page(s) 509–517

Abstract: Pneumonia is one of the most common reasons for health care utilization in the United States. It can be caused by many different pathogens, but rarely is it able to be identified in specific cases. This has led most racial disparities research to focus ... ...

Abstract	Pneumonia is one of the most common reasons for health care utilization in the United States. It can be caused by many different pathogens, but rarely is it able to be identified in specific cases. This has led most racial disparities research to focus on community acquired pneumonia and microbes of public health concern such as influenza, tuberculosis, and COVID-19. Differences have been shown to exist from prevention with vaccines to management and outcomes. COVID-19 has led to a significant increase in the awareness of this topic.
MeSH term(s)	Humans ; United States ; COVID-19 ; Influenza Vaccines/therapeutic use ; Influenza, Human/epidemiology ; Influenza, Human/prevention & control ; Pneumonia/therapy ; Vaccination
Chemical Substances	Influenza Vaccines
Language	English
Publishing date	2023-05-08
Publishing country	United States
Document type	Journal Article ; Review ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	447455-7
ISSN	1557-8216 ; 0272-5231
ISSN (online)	1557-8216
ISSN	0272-5231
DOI	10.1016/j.ccm.2023.03.007
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Article ; Online: U.S. Adult Critical Care Beds Per Capita: A 2021 County-Level Cross-Sectional Study.

Kempker, Jordan A / Stearns, Erin / Peterson, Emily N / Waller, Lance A

Critical care explorations

2023 Volume 5, Issue 3, Page(s) e0868

Abstract: Per capita geographic distribution of adult critical care beds can be utilized for healthcare resources assessments.: Objectives: Describe the per capita distribution of staffed adult critical care beds across the United States.: Design setting and ... ...

Abstract	Per capita geographic distribution of adult critical care beds can be utilized for healthcare resources assessments. Objectives: Describe the per capita distribution of staffed adult critical care beds across the United States. Design setting and participants: Cross-sectional epidemiologic assessment of November 2021 hospital data from the Department of Health and Human Services' Protect Public Data Hub. Main outcomes and measures: Staffed adult critical care beds per adult population. Results: The percent of hospitals reporting was high and varied by state/territory (median, 98.6% of states' hospitals reporting; interquartile range [IQR], 97.8-100%). There was a total of 4,846 adult hospitals accounting for 79,876 adult critical care beds in the United States and its territories. Crudely aggregated at the national-level, this calculated to 0.31 adult critical care beds per 1,000 adults. The median crude per capita density of adult critical care beds per 1,000 adults across U.S. counties was 0.00 per 1,000 adults (county, IQR 0.00-0.25; range, 0.00-8.65). Spatially smoothed county-level estimates were obtained using Empirical Bayes and Spatial Empirical Bayes approaches, resulting in an estimated 0.18 adult critical care beds per 1,000 adults (range from both methodological estimates, 0.00-8.20). When compared to counties in the lower quartile of adult critical care bed density, counties in the upper quartile had higher average adult population counts (mean 159,000 vs 32,000 adults per county) and a choropleth map demonstrated high densities of beds in urban centers with low density across rural areas. Conclusions and relevance: Among U.S. counties, the density of critical care beds per capita was not uniformly distributed, with high densities concentrated in highly populated urban centers and relative scarcity in rural areas. As it is unknown what defines deficiency and surplus in terms of outcomes and costs, this descriptive report serves as an additional methodological benchmark for hypothesis-driven research in this area.
Language	English
Publishing date	2023-02-24
Publishing country	United States
Document type	Journal Article
ISSN	2639-8028
ISSN (online)	2639-8028
DOI	10.1097/CCE.0000000000000868
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Article ; Online: Intermediate or Intensive Care Unit Admission across Race and Ethnicity.

Cheung, Patricia C / Kramer, Michael R / Kempker, Jordan A

Southern medical journal

2022 Volume 115, Issue 12, Page(s) 913–918

Abstract: Objectives: The aim of this study was to assess the association between race and ethnicity and admission to intermediate (IMCUs) or intensive care units (ICUs) among hospitalized patients.: Methods: Using Florida hospital discharge data from the ... ...

Abstract	Objectives: The aim of this study was to assess the association between race and ethnicity and admission to intermediate (IMCUs) or intensive care units (ICUs) among hospitalized patients. Methods: Using Florida hospital discharge data from the Agency for Healthcare Research and Quality-sponsored State Inpatient Database in 2017, we assessed the relationship between race (White, Black, Other) and Hispanic ethnicity and IMCU or ICU admission. Demographic covariates included age, sex, quartile of household income for patient ZIP code, insurance status, and patient residence. An adjusted model assessed the association between race and ethnicity and IMCU or ICU admission using log binomial regression with generalized estimating equations after controlling for demographic characteristics and the Elixhauser Comorbidity Index. Results: After controlling for demographics and comorbidities, the prevalence of IMCU or ICU admission was higher among non-Hispanic Blacks (adjusted prevalence ratio [aPR] 1.04; 95% confidence interval [CI] 1.02-1.05) and non-Hispanic patients of other races (aPR 1.03; 95% CI 1.01-1.04) compared with non-Hispanic Whites. The prevalence of IMCU or ICU use was lower among Hispanic Whites (aPR 0.98; 95% CI 0.86-1.00) and Hispanics of other races (aPR 0.96; 95% CI 0.95-0.98) compared with non-Hispanic Whites after controlling for other demographic characteristics and comorbidities. Conclusions: Among hospitalized patients, racial minorities are slightly more likely to use higher levels of care, whereas Hispanic patients are generally slightly less likely than non-Hispanic White patients to use higher levels of care. Further evaluation is needed to identify reasons for disparate IMCU or ICU admission.
MeSH term(s)	United States ; Humans ; Ethnicity ; Intensive Care Units ; Hospitalization ; Hispanic or Latino ; Blacks
Language	English
Publishing date	2022-11-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	185329-6
ISSN	1541-8243 ; 0038-4348
ISSN (online)	1541-8243
ISSN	0038-4348
DOI	10.14423/SMJ.0000000000001487
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Article ; Online: A global accounting of sepsis.

Kempker, Jordan A / Martin, Greg S

Lancet (London, England)

2020 Volume 395, Issue 10219, Page(s) 168–170

MeSH term(s)	Global Burden of Disease ; Global Health ; Humans ; Incidence ; Sepsis
Language	English
Publishing date	2020-01-16
Publishing country	England
Document type	Journal Article ; Comment
ZDB-ID	3306-6
ISSN	1474-547X ; 0023-7507 ; 0140-6736
ISSN (online)	1474-547X
ISSN	0023-7507 ; 0140-6736
DOI	10.1016/S0140-6736(19)33065-X
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Article ; Online: Definitions, Epidemiology, Clinical Risk Factors, and Health Disparities in Acute Respiratory Distress Syndrome.

Kang, Mohleen / Kempker, Jordan A

Seminars in respiratory and critical care medicine

2019 Volume 40, Issue 1, Page(s) 3–11

Abstract: Acute respiratory distress syndrome (ARDS) is a syndrome of inflammatory lung injury currently defined as the rapid onset of hypoxemia and radiographic opacities from a recent direct or indirect insult that is not explained by other causes. While the ... ...

Abstract	Acute respiratory distress syndrome (ARDS) is a syndrome of inflammatory lung injury currently defined as the rapid onset of hypoxemia and radiographic opacities from a recent direct or indirect insult that is not explained by other causes. While the diagnostic criteria used to define ARDS are helpful in the clinical setting, they are not entirely specific for the characteristic pathophysiology of diffuse alveolar lung damage. This case definition introduces challenges to the reliable and accurate epidemiologic study of the condition. Within these limitations, ARDS appears to be a condition that is relatively rare within the general population but common within the context of the intensive care unit. Furthermore, the frequency and outcomes of ARDS seem to vary between populations, with no clearly discernible temporal trends in incidence or case fatality that are uniform across studies.
MeSH term(s)	Health Status Disparities ; Humans ; Incidence ; Intensive Care Units ; Respiratory Distress Syndrome, Adult/epidemiology ; Respiratory Distress Syndrome, Adult/etiology ; Respiratory Distress Syndrome, Adult/physiopathology ; Risk Factors
Language	English
Publishing date	2019-05-06
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S. ; Review
ZDB-ID	1183617-9
ISSN	1098-9048 ; 1069-3424
ISSN (online)	1098-9048
ISSN	1069-3424
DOI	10.1055/s-0039-1683884
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Article ; Online: A Brief History of Time, As It Relates to ARDS.

Martin, Greg S / Kempker, Jordan A

Seminars in respiratory and critical care medicine

2019 Volume 40, Issue 1, Page(s) 1–2

MeSH term(s)	Evidence-Based Medicine ; Humans ; Respiratory Distress Syndrome/epidemiology ; Respiratory Distress Syndrome/therapy
Language	English
Publishing date	2019-05-06
Publishing country	United States
Document type	Introductory Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1183617-9
ISSN	1098-9048 ; 1069-3424
ISSN (online)	1098-9048
ISSN	1069-3424
DOI	10.1055/s-0039-1685211
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Article ; Online: Higher serum vitamin D levels are associated with decreased odds of obstructive lung disease in the general population: an NHANES analysis (2007-2008 to 2009-2010).

Seedahmed, Mohamed Ismail / Baugh, Aaron D / Kempker, Jordan A

BMJ open respiratory research

2021 Volume 7, Issue 1

Abstract: Background: Obstructive lung disease is a significant cause of morbidity and healthcare burden within the USA. A growing body of evidence has suggested that vitamin D levels can influence the course or incidence of obstructive lung disease. However, ... ...

Abstract	Background: Obstructive lung disease is a significant cause of morbidity and healthcare burden within the USA. A growing body of evidence has suggested that vitamin D levels can influence the course or incidence of obstructive lung disease. However, there is an insufficient previous investigation of this association. Study design and methods: We used the National Health and Nutrition Examination Survey (NHANES) cycles 2007-2008 and 2009-2010 spirometry results of individuals aged 40 years and older to assess the association between serum 25-hydroxyvitamin D levels and obstructive lung disease, as defined by the American Thoracic Society using the lower limit of normal. We used stage multivariate survey-logistic regression. Results: The final model included age, gender, body mass index, pack-years smoking history, season, income-to-poverty ratio and race/ethnicity. In the primary analysis using vitamin D as a continuous variable, there was no association between vitamin D levels and obstructive lung disease. We noted a trend between 'other Hispanic' self-identified race and serum vitamin D levels wherein higher levels were associated with higher odds of obstructive lung disease in this ethnicity, but not among other racial or ethnic groups (OR (95% CI)=1.40 (0.98 to 1.99), p=0.06). In a secondary analysis, when vitamin D was measured as a categorical variable, there was a significant association between the highest levels of serum vitamin D levels and lesser odds of obstructive lung disease (OR (95% CI)=0.77 [0.61 to 0.98], p Conclusions: Higher serum vitamin D levels among adults are associated with decreased odds of obstructive lung disease in the general population. Results among non-Mexican Hispanic participants highlight the need for further research in minority populations. More work is needed to address the course and incidence of lung disease in the USA.
MeSH term(s)	Adult ; Body Mass Index ; Humans ; Lung Diseases, Obstructive/epidemiology ; Middle Aged ; Nutrition Surveys ; Spirometry ; United States/epidemiology ; Vitamin D
Chemical Substances	Vitamin D (1406-16-2)
Language	English
Publishing date	2021-01-03
Publishing country	England
Document type	Journal Article
ZDB-ID	2736454-9
ISSN	2052-4439 ; 2052-4439
ISSN (online)	2052-4439
ISSN	2052-4439
DOI	10.1136/bmjresp-2020-000798
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Article ; Online: Severity and Timing of Onset Drive Economic Costs and Clinical Outcomes With Sepsis.

Kempker, Jordan A / Martin, Greg S

Critical care medicine

2018 Volume 46, Issue 12, Page(s) 2043–2044

MeSH term(s)	Hospital Mortality ; Humans ; Sepsis ; United States
Language	English
Publishing date	2018-11-16
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S. ; Comment
ZDB-ID	197890-1
ISSN	1530-0293 ; 0090-3493
ISSN (online)	1530-0293
ISSN	0090-3493
DOI	10.1097/CCM.0000000000003376
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Article ; Online: The Published Scientific Literature on COVID-19: An Analysis of PubMed Abstracts.

Kang, Mohleen / Gurbani, Saumya S / Kempker, Jordan A

Journal of medical systems

2020 Volume 45, Issue 1, Page(s) 3

MeSH term(s)	Bibliometrics ; COVID-19 ; Humans ; Pandemics ; PubMed ; Publications ; SARS-CoV-2
Language	English
Publishing date	2020-11-25
Publishing country	United States
Document type	Letter
ZDB-ID	423488-1
ISSN	1573-689X ; 0148-5598
ISSN (online)	1573-689X
ISSN	0148-5598
DOI	10.1007/s10916-020-01678-4
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Article: An updated approach to determine minimal clinically important differences in idiopathic pulmonary fibrosis.

Kang, Mohleen / Veeraraghavan, Srihari / Martin, Greg S / Kempker, Jordan A

ERJ open research

2021 Volume 7, Issue 4

Abstract: Introduction: Current medications for idiopathic pulmonary fibrosis (IPF) have not been shown to impact patient-reported outcome measures (PROMs), highlighting the need for accurate minimal clinically important difference (MCID) values. Recently ... ...

Abstract	Introduction: Current medications for idiopathic pulmonary fibrosis (IPF) have not been shown to impact patient-reported outcome measures (PROMs), highlighting the need for accurate minimal clinically important difference (MCID) values. Recently published consensus standards for MCID studies support using anchor-based over distribution-based methods. The aim of this study was to estimate MCID values for worsening in IPF using only an anchor-based approach. Methods: We conducted secondary analyses of three randomised controlled trials with different inclusion criteria and follow-up intervals. The health transition question in the 36-Item Short-Form Health Survey (SF-36) questionnaire was used as the anchor. We used receiver operating curves to assess responsiveness between the anchor and 10 variables (four physiological measures and six PROMs). We used an anchor-based method to determine the MCID values of variables that met the responsiveness criteria (area under the curve ≥0.70). Results: 6-min walk distance (6MWD), the St George's Respiratory Questionnaire (SGRQ), physical component score (PCS) of SF-36 and University of California, San Diego, Shortness of Breath Questionnaire (UCSD SOBQ) met the responsiveness criteria. The MCID value for 6MWD was -75 m; the MCID value for SF-36 PCS was -7 points; the MCID value for SGRQ was 11 points; and the MCID value for the UCSD SOBQ was 11 points. Conclusions: The MCID estimates of 6MWD, SGRQ, SF-36 and UCSD SOBQ using only anchor-based methods were considerably higher compared to previously proposed values. A single MCID value may not be applicable across all classes of disease severity or durations of follow-up time.
Language	English
Publishing date	2021-10-18
Publishing country	England
Document type	Journal Article
ZDB-ID	2827830-6
ISSN	2312-0541
ISSN	2312-0541
DOI	10.1183/23120541.00142-2021
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