2020, Kutz, Alexander, Ebrahimi, Fahim, Sailer, Clara O., Wagner, Ulrich, Schuetz, Philipp, Mueller, Beat, Christ-Crain, Mirjam

https://doi.org/10.1210/clinem/dgz320

2019, Kutz, Alexander, Gut, Lara, Ebrahimi, Fahim, Wagner, Ulrich, Schuetz, Philipp, Mueller, Beat

To examine the association of the SwissDRG implementation with length of hospital stay (LOS), in-hospital mortality, and 30-day readmission rates in the overall adult inpatient population and stratified by 5 individual diagnoses. CONCLUSIONS AND RELEVANCE Among medical hospitalizations in Switzerland, SwissDRG implementation appeared to be associated with an increase in readmission rates and a decrease in in-hospital mortality but not with the gradual decrease in LOS observed in the historical control period.

2020, Kutz, Alexander, Ebrahimi, Fahim, Aghlmandi, Soheila, Wagner, Ulrich, Bromley, Miluska, Illigens, Ben, Siepmann, Timo, Schuetz, Philipp, Mueller, Beat, Christ-Crain, Mirjam

Hyponatremia has been associated with excess long-term morbidity and mortality. However, effects during hospitalization are poorly studied. Objective The objective of this work is to examine the association of hyponatremia with the risk of in-hospital mortality, 30-day readmission, and other short-term adverse events among medical inpatients. Design and Setting A population-based cohort study was conducted using a Swiss claims database of medical inpatients from January 2012 to December 2017 Patients Hyponatremic patients were 1:1 propensity-score matched with normonatremic medical inpatients. Main Outcome Measure The primary outcome was a composite of all-cause in-hospital mortality and 30-day hospital readmission. Secondary outcomes were intensive care unit (ICU) admission, intubation rate, length-of-hospital stay (LOS), and patient disposition after discharge. Results After matching, 94 352 patients were included in the cohort. Among 47 176 patients with hyponatremia, 8383 (17.8%) reached the primary outcome compared with 7994 (17.0%) in the matched control group (odds ratio [OR] 1.06 [95% CI, 1.02-1.10], P = .001). Hyponatremic patients were more likely to be admitted to the ICU (OR 1.43 [95% CI, 1.37-1.50], P < .001), faced a 56% increase in prolonged LOS (95% CI, 1.52-1.60, P < .001), and were admitted more often to a postacute care facility (OR 1.38 [95% CI 1.34-1.42, P < .001). Of note, patients with the syndrome of inappropriate antidiuresis (SIAD) had lower in-hospital mortality (OR 0.67 [95% CI, 0.56-0.80], P < .001) as compared with matched normonatremic controls. Conclusion In this study, hyponatremia was associated with increased risk of short-term adverse events, primarily driven by higher readmission rates, which was consistent among all outcomes except for decreased in-hospital mortality in SIAD patients.

2019, Ebrahimi, Fahim, Widmer, Andrea, Wagner, Ulrich, Mueller, Beat, Schuetz, Philipp, Christ-Crain, Mirjam, Kutz, Alexander

2020, Ebrahimi, Fahim, Kutz, Alexander, Wagner, Ulrich, Illigens, Ben, Siepmann, Timo, Schuetz, Philipp, Christ-Crain, Mirjam, Mueller, Beat, Christ, Emanuel R.