Burden of illness associated with sinusoidal obstruction syndrome/veno-occlusive disease in patients with hematopoietic stem cell transplantation

Aims: Sinusoidal obstruction syndrome (SOS) is a life-threatening complication of hematopoietic stem cell transplantation (HSCT) associated with significant morbidity and mortality. Healthcare utilization, costs, and mortality were assessed in HSCT patients diagnosed with SOS, with and without multi-organ dysfunction (MOD).

Materials and methods: This retrospective observational study identified real-world patients undergoing HSCT between January 1, 2009 and May 31, 2014 using the Premier Healthcare Database. In absence of a formal ICD-9-CM diagnostic code, SOS patients were identified using a pre-specified definition adapted from Baltimore and Seattle criteria and clinical practice. Severe SOS (SOS/MOD) and non-severe SOS (SOS/no-MOD) were classified according to clinical evidence for MOD in the database.

Results: Of the 5,418 patients with a discharge diagnosis of HSCT, 291 had SOS, with 134 categorized as SOS/MOD and 157 as SOS/no-MOD. The remaining 5,127 patients had HSCT without SOS. Overall SOS incidence was 5.4%, with 46% having evidence of MOD. Distribution of age, gender, and race were similar between the SOS cohorts and non-SOS patients. After controlling for hospital profile and admission characteristics, demographics, and clinical characteristics, the adjusted mean LOS was 31.0 days in SOS/MOD compared to 23.9 days in the non-SOS cohort (medians?=?26.9 days vs 20.8 days, p?p?Limitations: Limitations of retrospective observational studies apply, since the study was not randomized. Definition for SOS was based on ICD-9 diagnosis codes from a hospital administrative database and reliant on completeness and accuracy of coding.

Conclusions: Analysis of real-world data shows that SOS/MOD is associated with significant increases in healthcare utilization, costs, and inpatient mortality.     

克服翻译症提高译文可接受性

可接受性直接反映着翻译质量。要提高翻译质量必须注重语言结构的调整,保证文化传真,克服翻译病,提高译文的可接受性。     

The burden of illness of hepatorenal syndrome (HRS) in the United States: a retrospective analysis of electronic health records

Objectives: Hepatorenal Syndrome (HRS) is characterized by renal failure in patients with advanced chronic liver disease (CLD) and is the leading cause of hospitalizations in CLD. This study examines the clinical and economic burden, outcomes, and unmet need of HRS treatment in US hospitals.

Method: A retrospective cohort study was conducted based on a large electronic health records database (Cerner HealthFacts) with records for hospitalized HRS patients from January 2009–June 2015. Demographics, clinical characteristics, treatment patterns, and economic outcomes were analyzed. Prognostic indicators of cirrhosis, kidney injury, end-stage liver disease, and acute-on-chronic liver failure were used to determine mortality risk.

Results: A total of 2,542 patients hospitalized with HRS were identified (average age = 57.9 years, 61.8% males, 74.2% Caucasian), with an average total hospital charge of $91,504 per patient and a mean length of stay (LOS) of 30.5?days. The mortality rate was 36.9% with 8.9% of patients discharged to hospice. Of all patients, 1,660 patients had acute kidney injury, 859 with Stage 3 disease, and 26.7% had dialysis. The 30-day readmission rate was 33.1%, 41% of which were unplanned. Nearly one-third of study patients had commercial insurance (30.2%), followed by Medicare (29.9%); hospital charges varied by LOS, receipt of dialysis, and discharge status. Regression analysis demonstrated that HRS costs are associated with LOS, dialysis, and hospital mortality.

Conclusion: HRS is associated with poor outcomes and high hospital costs. Analysis of HRS cost drivers demonstrated an unmet need for additional treatment options to improve outcomes in this patient population.     

自拟中药方剂养胃汤加减治疗慢性萎缩性胃炎患者的疗效

目的探讨自拟中药方剂养胃汤加减治疗慢性萎缩性胃炎患者的疗效。方法选取2018年11月至2019年11月营口市中医院收治的100例慢性萎缩性胃炎患者作为研究对象,随机分为胃复春片组与联合用药组,各50例。胃复春片组给予胃复春片,联合用药组在对照组治疗基础上采用自拟中药方剂养胃汤加减治疗,比较两组中医证候积分,炎症介质及胃泌素-17(G-17)、胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)水平,一氧化氮(NO)、超氧化物歧化酶(SOD)、丙二醛(MDA)水平及不良反应。结果治疗后联合用药组胃刺痛、胃脘胀满、食少纳呆、消瘦及乏力积分低于胃复春片组(P<0.05);治疗后,联合用药组CRP、TNF-α及IL-6水平低于胃复春片组(P<0.05),G-17、PGⅠ、PGⅡ高于胃复春片组(P<0.05);治疗后,联合用药组NO、SOD水平高于胃复春片组(P<0.05),MDA水平低于胃复春片组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论自拟中药方剂养胃汤加减治疗慢性萎缩性胃炎能有效缓解患者症状,减轻机体炎症反应,未增加不良反应发生率。