Abstract: SA-PO690
National Trends in Hospitalization in the US Calciphylaxis Population from 2007 to 2014
Session Information
- Bone and Mineral Metabolism: Clinical - II
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Bone and Mineral Metabolism
- 402 Bone and Mineral Metabolism: Clinical
Authors
- Garcia, Pablo, Stanford University, Palo Alto, California, United States
- Charilaou, Paris, Saint Peter's University Hospital, New Brunswick, New Jersey, United States
- Parada, Xavier F., Massachusetts General Hospital, Boston, Massachusetts, United States
- Funes-Hernandez, Mario Ricardo, Saint Peter''s University Hospital, Somerset, New Jersey, United States
- Nigwekar, Sagar U., Massachusetts General Hospital, Boston, Massachusetts, United States
Background
Calciphylaxis is a rare syndrome of vascular calcification characterized by occlusion of microvessels in the subcutaneous adipose tissue and dermis, resulting in painful, ischemic skin lesions. The definitive diagnosis is made by confirming the presence of calcified dermal arterioles on a skin biopsy in a patient with clinical suspicion for calciphylaxis. In this study we describe the trends and patient distribution and characteristics of calciphylaxis in the US inpatient population from 2007-2014.
Methods
We included all adult discharges from the National Inpatient Sample (NIS) from 2007-2014, from large (>=325 beds) teaching hospitals, excluding cases with missing data on age, gender, or inpatient mortality. We used a previously published algorithm to identify patients with calciphylaxis from the NIS. This algorithm applies the ICD-9-CM diagnosis code 275.49 “Other Disorders of Calcium Metabolism” in combination with the ICD-9 code 86.1.
Results
We identified 1576 probable calciphylaxis discharges from 2007 to 2014, with 69% patients on dialysis of which 90% where patients on HD, 54.8% were white and 70.5% were females. Mean age was 59 years (95% CI: 57 to 61 years). 35% belonged in the lowest income quartile and 17% belonged to the upper quartile in the US. Most patients were located in the Southern (39.8%) and Midwest (29%) Region of the US. 49% of the patients had DM, 19% were obese, 78% had HTN and 26% had A-Fib.
Overall inpatient mortality was 7.9%. The median length of stay was 11 days (range 0-98) and mean hospitalization cost was $31467 ±$2127. We found that 63% patients were discharged to rehab, skilled nursing facility or home with nurse care and 37% went home.
Conclusion
Calciphylaxis was more prevalent in females. One third of the patients belonged to the lowest income quartile. Most of the patients with calciphylaxis were located in the Southern and Midwest Region. Most of the patients were discharged to rehab, skilled nursing facility or home with nurse.