Sharon Worcester

CHICAGO – Reverse shoulder arthroplasty provides a surgical option for improving pain and ability in patients who have both arthritis and massive rotator cuff tear.

Before the procedure was approved for use in the United States in 2005, patients with this combination of conditions were very difficult to manage, said Dr. Matthew Saltzman at a symposium sponsored by the American College of Rheumatology.

"We didn’t have a solution for this problem for many, many years, but now I think we really do," said Dr. Saltzman, an orthopedic surgeon specializing in shoulder and elbow surgery at Northwestern University, Chicago.

Reverse shoulder arthroplasty basically changes the mechanics of the shoulder. It involves putting the ball in the socket, and putting the socket where the ball used to be, he said, adding that it’s "a strange concept, but it actually works."

"With reverse shoulder arthroplasty, you’re actually medializing the center of rotation, and this can be done to varying degrees depending on the implant design," he said, explaining that the procedure changes the tension on the deltoid muscle and allows the deltoid, rather than the irreparable rotator cuff musculature, to lift the arm.

Dr. Saltzman described two cases involving elderly women who underwent reverse shoulder arthroplasty and had excellent outcomes at 6-12 months. One was an 84-year-old who presented with a massive cuff tear as well as arthritis-related joint damage and loss of the joint space. Like many patients with these conditions, she had severe pain, pseudoparalysis of the shoulder, and resulting lack of function; she was able to lift her arm to only about 20 degrees.

At 6 months after the operation, she had no pain and was able to elevate her arm and rotate the arm out to the side.

The other patient was an 86-year-old who had previously lived independently, but who had slipped on ice and sustained multiple fractures of her shoulder. Although her problem wasn’t arthritis related, the reverse shoulder arthroplasty was successful, and she was able to return to independent living.

Findings from a study involving 240 consecutive reverse shoulder arthroplasty procedures in 232 patients (average age, nearly 73 years) showed that average forward elevation increased from 86 degrees to 137 degrees, and average constant score (a validated measure of shoulder function) improved from 23 to 60 at the latest follow-up, indicating substantial improvement, Dr. Saltzman said (J. Bone Joint Surg. Am. 2007;89:1476-85).

In that study, patients with cuff tear arthropathy, osteoarthritis plus cuff tear, or massive cuff tear fared better, whereas those with posttraumatic arthritis and those undergoing revision arthroplasty had worse outcomes.

Of course, patients need to be healthy enough to withstand surgery, but in appropriately selected patients this procedure provides a really nice result, he said.

"You’re taking a very severe problem and giving people a much better quality of life," he added.

Dr. Saltzman disclosed that he serves on the speakers bureau of Carefusion, has made paid presentations for DJO Surgical, and has received research support from Arthrex.

CHICAGO – Reverse shoulder arthroplasty provides a surgical option for improving pain and ability in patients who have both arthritis and massive rotator cuff tear.

Before the procedure was approved for use in the United States in 2005, patients with this combination of conditions were very difficult to manage, said Dr. Matthew Saltzman at a symposium sponsored by the American College of Rheumatology.

"We didn’t have a solution for this problem for many, many years, but now I think we really do," said Dr. Saltzman, an orthopedic surgeon specializing in shoulder and elbow surgery at Northwestern University, Chicago.

Reverse shoulder arthroplasty basically changes the mechanics of the shoulder. It involves putting the ball in the socket, and putting the socket where the ball used to be, he said, adding that it’s "a strange concept, but it actually works."

"With reverse shoulder arthroplasty, you’re actually medializing the center of rotation, and this can be done to varying degrees depending on the implant design," he said, explaining that the procedure changes the tension on the deltoid muscle and allows the deltoid, rather than the irreparable rotator cuff musculature, to lift the arm.

Dr. Saltzman described two cases involving elderly women who underwent reverse shoulder arthroplasty and had excellent outcomes at 6-12 months. One was an 84-year-old who presented with a massive cuff tear as well as arthritis-related joint damage and loss of the joint space. Like many patients with these conditions, she had severe pain, pseudoparalysis of the shoulder, and resulting lack of function; she was able to lift her arm to only about 20 degrees.

At 6 months after the operation, she had no pain and was able to elevate her arm and rotate the arm out to the side.

The other patient was an 86-year-old who had previously lived independently, but who had slipped on ice and sustained multiple fractures of her shoulder. Although her problem wasn’t arthritis related, the reverse shoulder arthroplasty was successful, and she was able to return to independent living.

Findings from a study involving 240 consecutive reverse shoulder arthroplasty procedures in 232 patients (average age, nearly 73 years) showed that average forward elevation increased from 86 degrees to 137 degrees, and average constant score (a validated measure of shoulder function) improved from 23 to 60 at the latest follow-up, indicating substantial improvement, Dr. Saltzman said (J. Bone Joint Surg. Am. 2007;89:1476-85).

In that study, patients with cuff tear arthropathy, osteoarthritis plus cuff tear, or massive cuff tear fared better, whereas those with posttraumatic arthritis and those undergoing revision arthroplasty had worse outcomes.

Of course, patients need to be healthy enough to withstand surgery, but in appropriately selected patients this procedure provides a really nice result, he said.

"You’re taking a very severe problem and giving people a much better quality of life," he added.

Dr. Saltzman disclosed that he serves on the speakers bureau of Carefusion, has made paid presentations for DJO Surgical, and has received research support from Arthrex.

CHICAGO – Reverse shoulder arthroplasty provides a surgical option for improving pain and ability in patients who have both arthritis and massive rotator cuff tear.

Before the procedure was approved for use in the United States in 2005, patients with this combination of conditions were very difficult to manage, said Dr. Matthew Saltzman at a symposium sponsored by the American College of Rheumatology.

"We didn’t have a solution for this problem for many, many years, but now I think we really do," said Dr. Saltzman, an orthopedic surgeon specializing in shoulder and elbow surgery at Northwestern University, Chicago.

Reverse shoulder arthroplasty basically changes the mechanics of the shoulder. It involves putting the ball in the socket, and putting the socket where the ball used to be, he said, adding that it’s "a strange concept, but it actually works."

"With reverse shoulder arthroplasty, you’re actually medializing the center of rotation, and this can be done to varying degrees depending on the implant design," he said, explaining that the procedure changes the tension on the deltoid muscle and allows the deltoid, rather than the irreparable rotator cuff musculature, to lift the arm.

Dr. Saltzman described two cases involving elderly women who underwent reverse shoulder arthroplasty and had excellent outcomes at 6-12 months. One was an 84-year-old who presented with a massive cuff tear as well as arthritis-related joint damage and loss of the joint space. Like many patients with these conditions, she had severe pain, pseudoparalysis of the shoulder, and resulting lack of function; she was able to lift her arm to only about 20 degrees.

At 6 months after the operation, she had no pain and was able to elevate her arm and rotate the arm out to the side.

The other patient was an 86-year-old who had previously lived independently, but who had slipped on ice and sustained multiple fractures of her shoulder. Although her problem wasn’t arthritis related, the reverse shoulder arthroplasty was successful, and she was able to return to independent living.

Findings from a study involving 240 consecutive reverse shoulder arthroplasty procedures in 232 patients (average age, nearly 73 years) showed that average forward elevation increased from 86 degrees to 137 degrees, and average constant score (a validated measure of shoulder function) improved from 23 to 60 at the latest follow-up, indicating substantial improvement, Dr. Saltzman said (J. Bone Joint Surg. Am. 2007;89:1476-85).

In that study, patients with cuff tear arthropathy, osteoarthritis plus cuff tear, or massive cuff tear fared better, whereas those with posttraumatic arthritis and those undergoing revision arthroplasty had worse outcomes.

Of course, patients need to be healthy enough to withstand surgery, but in appropriately selected patients this procedure provides a really nice result, he said.

"You’re taking a very severe problem and giving people a much better quality of life," he added.

Dr. Saltzman disclosed that he serves on the speakers bureau of Carefusion, has made paid presentations for DJO Surgical, and has received research support from Arthrex.

CHICAGO – Reverse shoulder arthroplasty provides a surgical option for improving pain and ability in patients who have both arthritis and massive rotator cuff tear.

Before the procedure was approved for use in the United States in 2005, patients with this combination of conditions were very difficult to manage, said Dr. Matthew Saltzman at a symposium sponsored by the American College of Rheumatology.

"We didn’t have a solution for this problem for many, many years, but now I think we really do," said Dr. Saltzman, an orthopedic surgeon specializing in shoulder and elbow surgery at Northwestern University, Chicago.

Reverse shoulder arthroplasty basically changes the mechanics of the shoulder. It involves putting the ball in the socket, and putting the socket where the ball used to be, he said, adding that it’s "a strange concept, but it actually works."

"With reverse shoulder arthroplasty, you’re actually medializing the center of rotation, and this can be done to varying degrees depending on the implant design," he said, explaining that the procedure changes the tension on the deltoid muscle and allows the deltoid, rather than the irreparable rotator cuff musculature, to lift the arm.

Dr. Saltzman described two cases involving elderly women who underwent reverse shoulder arthroplasty and had excellent outcomes at 6-12 months. One was an 84-year-old who presented with a massive cuff tear as well as arthritis-related joint damage and loss of the joint space. Like many patients with these conditions, she had severe pain, pseudoparalysis of the shoulder, and resulting lack of function; she was able to lift her arm to only about 20 degrees.

At 6 months after the operation, she had no pain and was able to elevate her arm and rotate the arm out to the side.

The other patient was an 86-year-old who had previously lived independently, but who had slipped on ice and sustained multiple fractures of her shoulder. Although her problem wasn’t arthritis related, the reverse shoulder arthroplasty was successful, and she was able to return to independent living.

Findings from a study involving 240 consecutive reverse shoulder arthroplasty procedures in 232 patients (average age, nearly 73 years) showed that average forward elevation increased from 86 degrees to 137 degrees, and average constant score (a validated measure of shoulder function) improved from 23 to 60 at the latest follow-up, indicating substantial improvement, Dr. Saltzman said (J. Bone Joint Surg. Am. 2007;89:1476-85).

In that study, patients with cuff tear arthropathy, osteoarthritis plus cuff tear, or massive cuff tear fared better, whereas those with posttraumatic arthritis and those undergoing revision arthroplasty had worse outcomes.

Of course, patients need to be healthy enough to withstand surgery, but in appropriately selected patients this procedure provides a really nice result, he said.

"You’re taking a very severe problem and giving people a much better quality of life," he added.

Dr. Saltzman disclosed that he serves on the speakers bureau of Carefusion, has made paid presentations for DJO Surgical, and has received research support from Arthrex.

CHICAGO – Reverse shoulder arthroplasty provides a surgical option for improving pain and ability in patients who have both arthritis and massive rotator cuff tear.

Before the procedure was approved for use in the United States in 2005, patients with this combination of conditions were very difficult to manage, said Dr. Matthew Saltzman at a symposium sponsored by the American College of Rheumatology.

"We didn’t have a solution for this problem for many, many years, but now I think we really do," said Dr. Saltzman, an orthopedic surgeon specializing in shoulder and elbow surgery at Northwestern University, Chicago.

Reverse shoulder arthroplasty basically changes the mechanics of the shoulder. It involves putting the ball in the socket, and putting the socket where the ball used to be, he said, adding that it’s "a strange concept, but it actually works."

"With reverse shoulder arthroplasty, you’re actually medializing the center of rotation, and this can be done to varying degrees depending on the implant design," he said, explaining that the procedure changes the tension on the deltoid muscle and allows the deltoid, rather than the irreparable rotator cuff musculature, to lift the arm.

Dr. Saltzman described two cases involving elderly women who underwent reverse shoulder arthroplasty and had excellent outcomes at 6-12 months. One was an 84-year-old who presented with a massive cuff tear as well as arthritis-related joint damage and loss of the joint space. Like many patients with these conditions, she had severe pain, pseudoparalysis of the shoulder, and resulting lack of function; she was able to lift her arm to only about 20 degrees.

At 6 months after the operation, she had no pain and was able to elevate her arm and rotate the arm out to the side.

The other patient was an 86-year-old who had previously lived independently, but who had slipped on ice and sustained multiple fractures of her shoulder. Although her problem wasn’t arthritis related, the reverse shoulder arthroplasty was successful, and she was able to return to independent living.

Findings from a study involving 240 consecutive reverse shoulder arthroplasty procedures in 232 patients (average age, nearly 73 years) showed that average forward elevation increased from 86 degrees to 137 degrees, and average constant score (a validated measure of shoulder function) improved from 23 to 60 at the latest follow-up, indicating substantial improvement, Dr. Saltzman said (J. Bone Joint Surg. Am. 2007;89:1476-85).

In that study, patients with cuff tear arthropathy, osteoarthritis plus cuff tear, or massive cuff tear fared better, whereas those with posttraumatic arthritis and those undergoing revision arthroplasty had worse outcomes.

Of course, patients need to be healthy enough to withstand surgery, but in appropriately selected patients this procedure provides a really nice result, he said.

"You’re taking a very severe problem and giving people a much better quality of life," he added.

Dr. Saltzman disclosed that he serves on the speakers bureau of Carefusion, has made paid presentations for DJO Surgical, and has received research support from Arthrex.

CHICAGO – Reverse shoulder arthroplasty provides a surgical option for improving pain and ability in patients who have both arthritis and massive rotator cuff tear.

Before the procedure was approved for use in the United States in 2005, patients with this combination of conditions were very difficult to manage, said Dr. Matthew Saltzman at a symposium sponsored by the American College of Rheumatology.

"We didn’t have a solution for this problem for many, many years, but now I think we really do," said Dr. Saltzman, an orthopedic surgeon specializing in shoulder and elbow surgery at Northwestern University, Chicago.

Reverse shoulder arthroplasty basically changes the mechanics of the shoulder. It involves putting the ball in the socket, and putting the socket where the ball used to be, he said, adding that it’s "a strange concept, but it actually works."

"With reverse shoulder arthroplasty, you’re actually medializing the center of rotation, and this can be done to varying degrees depending on the implant design," he said, explaining that the procedure changes the tension on the deltoid muscle and allows the deltoid, rather than the irreparable rotator cuff musculature, to lift the arm.

Dr. Saltzman described two cases involving elderly women who underwent reverse shoulder arthroplasty and had excellent outcomes at 6-12 months. One was an 84-year-old who presented with a massive cuff tear as well as arthritis-related joint damage and loss of the joint space. Like many patients with these conditions, she had severe pain, pseudoparalysis of the shoulder, and resulting lack of function; she was able to lift her arm to only about 20 degrees.

At 6 months after the operation, she had no pain and was able to elevate her arm and rotate the arm out to the side.

The other patient was an 86-year-old who had previously lived independently, but who had slipped on ice and sustained multiple fractures of her shoulder. Although her problem wasn’t arthritis related, the reverse shoulder arthroplasty was successful, and she was able to return to independent living.

Findings from a study involving 240 consecutive reverse shoulder arthroplasty procedures in 232 patients (average age, nearly 73 years) showed that average forward elevation increased from 86 degrees to 137 degrees, and average constant score (a validated measure of shoulder function) improved from 23 to 60 at the latest follow-up, indicating substantial improvement, Dr. Saltzman said (J. Bone Joint Surg. Am. 2007;89:1476-85).

In that study, patients with cuff tear arthropathy, osteoarthritis plus cuff tear, or massive cuff tear fared better, whereas those with posttraumatic arthritis and those undergoing revision arthroplasty had worse outcomes.

Of course, patients need to be healthy enough to withstand surgery, but in appropriately selected patients this procedure provides a really nice result, he said.

"You’re taking a very severe problem and giving people a much better quality of life," he added.

Dr. Saltzman disclosed that he serves on the speakers bureau of Carefusion, has made paid presentations for DJO Surgical, and has received research support from Arthrex.

CHICAGO – Reverse shoulder arthroplasty provides a surgical option for improving pain and ability in patients who have both arthritis and massive rotator cuff tear.

Before the procedure was approved for use in the United States in 2005, patients with this combination of conditions were very difficult to manage, said Dr. Matthew Saltzman at a symposium sponsored by the American College of Rheumatology.

"We didn’t have a solution for this problem for many, many years, but now I think we really do," said Dr. Saltzman, an orthopedic surgeon specializing in shoulder and elbow surgery at Northwestern University, Chicago.

Reverse shoulder arthroplasty basically changes the mechanics of the shoulder. It involves putting the ball in the socket, and putting the socket where the ball used to be, he said, adding that it’s "a strange concept, but it actually works."

"With reverse shoulder arthroplasty, you’re actually medializing the center of rotation, and this can be done to varying degrees depending on the implant design," he said, explaining that the procedure changes the tension on the deltoid muscle and allows the deltoid, rather than the irreparable rotator cuff musculature, to lift the arm.

Dr. Saltzman described two cases involving elderly women who underwent reverse shoulder arthroplasty and had excellent outcomes at 6-12 months. One was an 84-year-old who presented with a massive cuff tear as well as arthritis-related joint damage and loss of the joint space. Like many patients with these conditions, she had severe pain, pseudoparalysis of the shoulder, and resulting lack of function; she was able to lift her arm to only about 20 degrees.

At 6 months after the operation, she had no pain and was able to elevate her arm and rotate the arm out to the side.

The other patient was an 86-year-old who had previously lived independently, but who had slipped on ice and sustained multiple fractures of her shoulder. Although her problem wasn’t arthritis related, the reverse shoulder arthroplasty was successful, and she was able to return to independent living.

Findings from a study involving 240 consecutive reverse shoulder arthroplasty procedures in 232 patients (average age, nearly 73 years) showed that average forward elevation increased from 86 degrees to 137 degrees, and average constant score (a validated measure of shoulder function) improved from 23 to 60 at the latest follow-up, indicating substantial improvement, Dr. Saltzman said (J. Bone Joint Surg. Am. 2007;89:1476-85).

In that study, patients with cuff tear arthropathy, osteoarthritis plus cuff tear, or massive cuff tear fared better, whereas those with posttraumatic arthritis and those undergoing revision arthroplasty had worse outcomes.

Of course, patients need to be healthy enough to withstand surgery, but in appropriately selected patients this procedure provides a really nice result, he said.

"You’re taking a very severe problem and giving people a much better quality of life," he added.

Dr. Saltzman disclosed that he serves on the speakers bureau of Carefusion, has made paid presentations for DJO Surgical, and has received research support from Arthrex.

CHICAGO – Reverse shoulder arthroplasty provides a surgical option for improving pain and ability in patients who have both arthritis and massive rotator cuff tear.

Before the procedure was approved for use in the United States in 2005, patients with this combination of conditions were very difficult to manage, said Dr. Matthew Saltzman at a symposium sponsored by the American College of Rheumatology.

"We didn’t have a solution for this problem for many, many years, but now I think we really do," said Dr. Saltzman, an orthopedic surgeon specializing in shoulder and elbow surgery at Northwestern University, Chicago.

Reverse shoulder arthroplasty basically changes the mechanics of the shoulder. It involves putting the ball in the socket, and putting the socket where the ball used to be, he said, adding that it’s "a strange concept, but it actually works."

"With reverse shoulder arthroplasty, you’re actually medializing the center of rotation, and this can be done to varying degrees depending on the implant design," he said, explaining that the procedure changes the tension on the deltoid muscle and allows the deltoid, rather than the irreparable rotator cuff musculature, to lift the arm.

Dr. Saltzman described two cases involving elderly women who underwent reverse shoulder arthroplasty and had excellent outcomes at 6-12 months. One was an 84-year-old who presented with a massive cuff tear as well as arthritis-related joint damage and loss of the joint space. Like many patients with these conditions, she had severe pain, pseudoparalysis of the shoulder, and resulting lack of function; she was able to lift her arm to only about 20 degrees.

At 6 months after the operation, she had no pain and was able to elevate her arm and rotate the arm out to the side.

The other patient was an 86-year-old who had previously lived independently, but who had slipped on ice and sustained multiple fractures of her shoulder. Although her problem wasn’t arthritis related, the reverse shoulder arthroplasty was successful, and she was able to return to independent living.

Findings from a study involving 240 consecutive reverse shoulder arthroplasty procedures in 232 patients (average age, nearly 73 years) showed that average forward elevation increased from 86 degrees to 137 degrees, and average constant score (a validated measure of shoulder function) improved from 23 to 60 at the latest follow-up, indicating substantial improvement, Dr. Saltzman said (J. Bone Joint Surg. Am. 2007;89:1476-85).

In that study, patients with cuff tear arthropathy, osteoarthritis plus cuff tear, or massive cuff tear fared better, whereas those with posttraumatic arthritis and those undergoing revision arthroplasty had worse outcomes.

Of course, patients need to be healthy enough to withstand surgery, but in appropriately selected patients this procedure provides a really nice result, he said.

"You’re taking a very severe problem and giving people a much better quality of life," he added.

Dr. Saltzman disclosed that he serves on the speakers bureau of Carefusion, has made paid presentations for DJO Surgical, and has received research support from Arthrex.

CHICAGO – Reverse shoulder arthroplasty provides a surgical option for improving pain and ability in patients who have both arthritis and massive rotator cuff tear.

Before the procedure was approved for use in the United States in 2005, patients with this combination of conditions were very difficult to manage, said Dr. Matthew Saltzman at a symposium sponsored by the American College of Rheumatology.

"We didn’t have a solution for this problem for many, many years, but now I think we really do," said Dr. Saltzman, an orthopedic surgeon specializing in shoulder and elbow surgery at Northwestern University, Chicago.

Reverse shoulder arthroplasty basically changes the mechanics of the shoulder. It involves putting the ball in the socket, and putting the socket where the ball used to be, he said, adding that it’s "a strange concept, but it actually works."

"With reverse shoulder arthroplasty, you’re actually medializing the center of rotation, and this can be done to varying degrees depending on the implant design," he said, explaining that the procedure changes the tension on the deltoid muscle and allows the deltoid, rather than the irreparable rotator cuff musculature, to lift the arm.

Dr. Saltzman described two cases involving elderly women who underwent reverse shoulder arthroplasty and had excellent outcomes at 6-12 months. One was an 84-year-old who presented with a massive cuff tear as well as arthritis-related joint damage and loss of the joint space. Like many patients with these conditions, she had severe pain, pseudoparalysis of the shoulder, and resulting lack of function; she was able to lift her arm to only about 20 degrees.

At 6 months after the operation, she had no pain and was able to elevate her arm and rotate the arm out to the side.

The other patient was an 86-year-old who had previously lived independently, but who had slipped on ice and sustained multiple fractures of her shoulder. Although her problem wasn’t arthritis related, the reverse shoulder arthroplasty was successful, and she was able to return to independent living.

Findings from a study involving 240 consecutive reverse shoulder arthroplasty procedures in 232 patients (average age, nearly 73 years) showed that average forward elevation increased from 86 degrees to 137 degrees, and average constant score (a validated measure of shoulder function) improved from 23 to 60 at the latest follow-up, indicating substantial improvement, Dr. Saltzman said (J. Bone Joint Surg. Am. 2007;89:1476-85).

In that study, patients with cuff tear arthropathy, osteoarthritis plus cuff tear, or massive cuff tear fared better, whereas those with posttraumatic arthritis and those undergoing revision arthroplasty had worse outcomes.

Of course, patients need to be healthy enough to withstand surgery, but in appropriately selected patients this procedure provides a really nice result, he said.

"You’re taking a very severe problem and giving people a much better quality of life," he added.

Dr. Saltzman disclosed that he serves on the speakers bureau of Carefusion, has made paid presentations for DJO Surgical, and has received research support from Arthrex.

LAKE BUENA VISTA, FLA. – Several factors were shown to predict decreased survival following open abdominal aortic aneurysm repair, according to a retrospective study of 408 patients.

For example, the clamp site – which was infrarenal in 33.6% of patients, suprarenal in 23.8% of patients, and supraceliac in 42.6% of patients – was found on multivariate analysis to be a statistically significant predictor of 5-year survival, Dr. Derek P. Nathan reported at the annual meeting of the Society for Clinical Vascular Surgery.

The 5-year survival was 74% with infrarenal site, compared with 65% for suprarenal site and 53% for supraceliac site, said Dr. Nathan of the Hospital of the University of Pennsylvania, Philadelphia.

Other factors that were found to significantly predict survival in this study were chronic obstructive pulmonary disease, renal insufficiency, and nonelective repair, all of which were significant predictors of both 30-day and 5-year survival. Cardiovascular disease, renal complications, and pulmonary complications were significant predictors of 5-year survival.

The 30-day survival rates were 92% in patients with COPD vs. 97% in those without; 92% in patients with renal insufficiency vs. 98% in those without; and 90% in patients undergoing nonelective repair vs. 97% in those having elective repair.

The 5-year survival rates were 56% in patients with COPD vs. 68% in those without; 52% in those with renal insufficiency vs. 73% in those without; 43% in patients undergoing nonelective repair vs. 68% in those having elective repair; 47% in patients with cardiovascular disease vs. 68% in those without; 41% in patients who sustained renal complications vs. 72% in those who did not; and 46% in patients who sustained pulmonary complications vs. 66% in those who did not, Dr. Nathan said.

Coronary artery disease was not found to predict either 30-day or 5-year survival, COPD did not predict 30-day survival, and cardiac complications did not predict 5-year survival, he noted.

Overall survival in this study of 289 men and 119 women (mean age, 72 years) who underwent open abdominal aortic aneurysm repair during the era of stent grafting was 96% at 30 days, 90% at 1 year, and 64% at 5 years.

Coronary artery disease was present in 56% of patients, renal insufficiency was present in 43%, COPD was present in 30%, and cerebrovascular disease was present in 18%. The mean aneurysm maximal diameter was 6.3 cm, and 67% of patients underwent nonelective repair.

Renal, cardiac, and pulmonary complications occurred in 19%, 17%, and 11% of patients, respectively.

Although the findings show that open AAA repair can be accomplished with low mortality, they underscore the need for careful patient selection, as well as diligent intraoperative technique and postoperative care, for optimizing results, Dr. Nathan concluded.

Dr. Nathan had no disclosures.

LAKE BUENA VISTA, FLA. – Several factors were shown to predict decreased survival following open abdominal aortic aneurysm repair, according to a retrospective study of 408 patients.

For example, the clamp site – which was infrarenal in 33.6% of patients, suprarenal in 23.8% of patients, and supraceliac in 42.6% of patients – was found on multivariate analysis to be a statistically significant predictor of 5-year survival, Dr. Derek P. Nathan reported at the annual meeting of the Society for Clinical Vascular Surgery.

The 5-year survival was 74% with infrarenal site, compared with 65% for suprarenal site and 53% for supraceliac site, said Dr. Nathan of the Hospital of the University of Pennsylvania, Philadelphia.

Other factors that were found to significantly predict survival in this study were chronic obstructive pulmonary disease, renal insufficiency, and nonelective repair, all of which were significant predictors of both 30-day and 5-year survival. Cardiovascular disease, renal complications, and pulmonary complications were significant predictors of 5-year survival.

The 30-day survival rates were 92% in patients with COPD vs. 97% in those without; 92% in patients with renal insufficiency vs. 98% in those without; and 90% in patients undergoing nonelective repair vs. 97% in those having elective repair.

The 5-year survival rates were 56% in patients with COPD vs. 68% in those without; 52% in those with renal insufficiency vs. 73% in those without; 43% in patients undergoing nonelective repair vs. 68% in those having elective repair; 47% in patients with cardiovascular disease vs. 68% in those without; 41% in patients who sustained renal complications vs. 72% in those who did not; and 46% in patients who sustained pulmonary complications vs. 66% in those who did not, Dr. Nathan said.

Coronary artery disease was not found to predict either 30-day or 5-year survival, COPD did not predict 30-day survival, and cardiac complications did not predict 5-year survival, he noted.

Overall survival in this study of 289 men and 119 women (mean age, 72 years) who underwent open abdominal aortic aneurysm repair during the era of stent grafting was 96% at 30 days, 90% at 1 year, and 64% at 5 years.

Coronary artery disease was present in 56% of patients, renal insufficiency was present in 43%, COPD was present in 30%, and cerebrovascular disease was present in 18%. The mean aneurysm maximal diameter was 6.3 cm, and 67% of patients underwent nonelective repair.

Renal, cardiac, and pulmonary complications occurred in 19%, 17%, and 11% of patients, respectively.

Although the findings show that open AAA repair can be accomplished with low mortality, they underscore the need for careful patient selection, as well as diligent intraoperative technique and postoperative care, for optimizing results, Dr. Nathan concluded.

Dr. Nathan had no disclosures.

LAKE BUENA VISTA, FLA. – Several factors were shown to predict decreased survival following open abdominal aortic aneurysm repair, according to a retrospective study of 408 patients.

For example, the clamp site – which was infrarenal in 33.6% of patients, suprarenal in 23.8% of patients, and supraceliac in 42.6% of patients – was found on multivariate analysis to be a statistically significant predictor of 5-year survival, Dr. Derek P. Nathan reported at the annual meeting of the Society for Clinical Vascular Surgery.

The 5-year survival was 74% with infrarenal site, compared with 65% for suprarenal site and 53% for supraceliac site, said Dr. Nathan of the Hospital of the University of Pennsylvania, Philadelphia.

Other factors that were found to significantly predict survival in this study were chronic obstructive pulmonary disease, renal insufficiency, and nonelective repair, all of which were significant predictors of both 30-day and 5-year survival. Cardiovascular disease, renal complications, and pulmonary complications were significant predictors of 5-year survival.

The 30-day survival rates were 92% in patients with COPD vs. 97% in those without; 92% in patients with renal insufficiency vs. 98% in those without; and 90% in patients undergoing nonelective repair vs. 97% in those having elective repair.

The 5-year survival rates were 56% in patients with COPD vs. 68% in those without; 52% in those with renal insufficiency vs. 73% in those without; 43% in patients undergoing nonelective repair vs. 68% in those having elective repair; 47% in patients with cardiovascular disease vs. 68% in those without; 41% in patients who sustained renal complications vs. 72% in those who did not; and 46% in patients who sustained pulmonary complications vs. 66% in those who did not, Dr. Nathan said.

Coronary artery disease was not found to predict either 30-day or 5-year survival, COPD did not predict 30-day survival, and cardiac complications did not predict 5-year survival, he noted.

Overall survival in this study of 289 men and 119 women (mean age, 72 years) who underwent open abdominal aortic aneurysm repair during the era of stent grafting was 96% at 30 days, 90% at 1 year, and 64% at 5 years.

Coronary artery disease was present in 56% of patients, renal insufficiency was present in 43%, COPD was present in 30%, and cerebrovascular disease was present in 18%. The mean aneurysm maximal diameter was 6.3 cm, and 67% of patients underwent nonelective repair.

Renal, cardiac, and pulmonary complications occurred in 19%, 17%, and 11% of patients, respectively.

Although the findings show that open AAA repair can be accomplished with low mortality, they underscore the need for careful patient selection, as well as diligent intraoperative technique and postoperative care, for optimizing results, Dr. Nathan concluded.

Dr. Nathan had no disclosures.

LAKE BUENA VISTA, FLA. – Several factors were shown to predict decreased survival following open abdominal aortic aneurysm repair, according to a retrospective study of 408 patients.

For example, the clamp site – which was infrarenal in 33.6% of patients, suprarenal in 23.8% of patients, and supraceliac in 42.6% of patients – was found on multivariate analysis to be a statistically significant predictor of 5-year survival, Dr. Derek P. Nathan reported at the annual meeting of the Society for Clinical Vascular Surgery.

The 5-year survival was 74% with infrarenal site, compared with 65% for suprarenal site and 53% for supraceliac site, said Dr. Nathan of the Hospital of the University of Pennsylvania, Philadelphia.

Other factors that were found to significantly predict survival in this study were chronic obstructive pulmonary disease, renal insufficiency, and nonelective repair, all of which were significant predictors of both 30-day and 5-year survival. Cardiovascular disease, renal complications, and pulmonary complications were significant predictors of 5-year survival.

The 30-day survival rates were 92% in patients with COPD vs. 97% in those without; 92% in patients with renal insufficiency vs. 98% in those without; and 90% in patients undergoing nonelective repair vs. 97% in those having elective repair.

The 5-year survival rates were 56% in patients with COPD vs. 68% in those without; 52% in those with renal insufficiency vs. 73% in those without; 43% in patients undergoing nonelective repair vs. 68% in those having elective repair; 47% in patients with cardiovascular disease vs. 68% in those without; 41% in patients who sustained renal complications vs. 72% in those who did not; and 46% in patients who sustained pulmonary complications vs. 66% in those who did not, Dr. Nathan said.

Coronary artery disease was not found to predict either 30-day or 5-year survival, COPD did not predict 30-day survival, and cardiac complications did not predict 5-year survival, he noted.

Overall survival in this study of 289 men and 119 women (mean age, 72 years) who underwent open abdominal aortic aneurysm repair during the era of stent grafting was 96% at 30 days, 90% at 1 year, and 64% at 5 years.

Coronary artery disease was present in 56% of patients, renal insufficiency was present in 43%, COPD was present in 30%, and cerebrovascular disease was present in 18%. The mean aneurysm maximal diameter was 6.3 cm, and 67% of patients underwent nonelective repair.

Renal, cardiac, and pulmonary complications occurred in 19%, 17%, and 11% of patients, respectively.

Although the findings show that open AAA repair can be accomplished with low mortality, they underscore the need for careful patient selection, as well as diligent intraoperative technique and postoperative care, for optimizing results, Dr. Nathan concluded.

Dr. Nathan had no disclosures.

LAKE BUENA VISTA, FLA. – Several factors were shown to predict decreased survival following open abdominal aortic aneurysm repair, according to a retrospective study of 408 patients.

For example, the clamp site – which was infrarenal in 33.6% of patients, suprarenal in 23.8% of patients, and supraceliac in 42.6% of patients – was found on multivariate analysis to be a statistically significant predictor of 5-year survival, Dr. Derek P. Nathan reported at the annual meeting of the Society for Clinical Vascular Surgery.

The 5-year survival was 74% with infrarenal site, compared with 65% for suprarenal site and 53% for supraceliac site, said Dr. Nathan of the Hospital of the University of Pennsylvania, Philadelphia.

Other factors that were found to significantly predict survival in this study were chronic obstructive pulmonary disease, renal insufficiency, and nonelective repair, all of which were significant predictors of both 30-day and 5-year survival. Cardiovascular disease, renal complications, and pulmonary complications were significant predictors of 5-year survival.

The 30-day survival rates were 92% in patients with COPD vs. 97% in those without; 92% in patients with renal insufficiency vs. 98% in those without; and 90% in patients undergoing nonelective repair vs. 97% in those having elective repair.

The 5-year survival rates were 56% in patients with COPD vs. 68% in those without; 52% in those with renal insufficiency vs. 73% in those without; 43% in patients undergoing nonelective repair vs. 68% in those having elective repair; 47% in patients with cardiovascular disease vs. 68% in those without; 41% in patients who sustained renal complications vs. 72% in those who did not; and 46% in patients who sustained pulmonary complications vs. 66% in those who did not, Dr. Nathan said.

Coronary artery disease was not found to predict either 30-day or 5-year survival, COPD did not predict 30-day survival, and cardiac complications did not predict 5-year survival, he noted.

Overall survival in this study of 289 men and 119 women (mean age, 72 years) who underwent open abdominal aortic aneurysm repair during the era of stent grafting was 96% at 30 days, 90% at 1 year, and 64% at 5 years.

Coronary artery disease was present in 56% of patients, renal insufficiency was present in 43%, COPD was present in 30%, and cerebrovascular disease was present in 18%. The mean aneurysm maximal diameter was 6.3 cm, and 67% of patients underwent nonelective repair.

Renal, cardiac, and pulmonary complications occurred in 19%, 17%, and 11% of patients, respectively.

Although the findings show that open AAA repair can be accomplished with low mortality, they underscore the need for careful patient selection, as well as diligent intraoperative technique and postoperative care, for optimizing results, Dr. Nathan concluded.

Dr. Nathan had no disclosures.

LAKE BUENA VISTA, FLA. – Several factors were shown to predict decreased survival following open abdominal aortic aneurysm repair, according to a retrospective study of 408 patients.

For example, the clamp site – which was infrarenal in 33.6% of patients, suprarenal in 23.8% of patients, and supraceliac in 42.6% of patients – was found on multivariate analysis to be a statistically significant predictor of 5-year survival, Dr. Derek P. Nathan reported at the annual meeting of the Society for Clinical Vascular Surgery.

The 5-year survival was 74% with infrarenal site, compared with 65% for suprarenal site and 53% for supraceliac site, said Dr. Nathan of the Hospital of the University of Pennsylvania, Philadelphia.

Other factors that were found to significantly predict survival in this study were chronic obstructive pulmonary disease, renal insufficiency, and nonelective repair, all of which were significant predictors of both 30-day and 5-year survival. Cardiovascular disease, renal complications, and pulmonary complications were significant predictors of 5-year survival.

The 30-day survival rates were 92% in patients with COPD vs. 97% in those without; 92% in patients with renal insufficiency vs. 98% in those without; and 90% in patients undergoing nonelective repair vs. 97% in those having elective repair.

The 5-year survival rates were 56% in patients with COPD vs. 68% in those without; 52% in those with renal insufficiency vs. 73% in those without; 43% in patients undergoing nonelective repair vs. 68% in those having elective repair; 47% in patients with cardiovascular disease vs. 68% in those without; 41% in patients who sustained renal complications vs. 72% in those who did not; and 46% in patients who sustained pulmonary complications vs. 66% in those who did not, Dr. Nathan said.

Coronary artery disease was not found to predict either 30-day or 5-year survival, COPD did not predict 30-day survival, and cardiac complications did not predict 5-year survival, he noted.

Overall survival in this study of 289 men and 119 women (mean age, 72 years) who underwent open abdominal aortic aneurysm repair during the era of stent grafting was 96% at 30 days, 90% at 1 year, and 64% at 5 years.

Coronary artery disease was present in 56% of patients, renal insufficiency was present in 43%, COPD was present in 30%, and cerebrovascular disease was present in 18%. The mean aneurysm maximal diameter was 6.3 cm, and 67% of patients underwent nonelective repair.

Renal, cardiac, and pulmonary complications occurred in 19%, 17%, and 11% of patients, respectively.

Although the findings show that open AAA repair can be accomplished with low mortality, they underscore the need for careful patient selection, as well as diligent intraoperative technique and postoperative care, for optimizing results, Dr. Nathan concluded.

Dr. Nathan had no disclosures.

LAKE BUENA VISTA, FLA. – Several factors were shown to predict decreased survival following open abdominal aortic aneurysm repair, according to a retrospective study of 408 patients.

For example, the clamp site – which was infrarenal in 33.6% of patients, suprarenal in 23.8% of patients, and supraceliac in 42.6% of patients – was found on multivariate analysis to be a statistically significant predictor of 5-year survival, Dr. Derek P. Nathan reported at the annual meeting of the Society for Clinical Vascular Surgery.

The 5-year survival was 74% with infrarenal site, compared with 65% for suprarenal site and 53% for supraceliac site, said Dr. Nathan of the Hospital of the University of Pennsylvania, Philadelphia.

Other factors that were found to significantly predict survival in this study were chronic obstructive pulmonary disease, renal insufficiency, and nonelective repair, all of which were significant predictors of both 30-day and 5-year survival. Cardiovascular disease, renal complications, and pulmonary complications were significant predictors of 5-year survival.

The 30-day survival rates were 92% in patients with COPD vs. 97% in those without; 92% in patients with renal insufficiency vs. 98% in those without; and 90% in patients undergoing nonelective repair vs. 97% in those having elective repair.

The 5-year survival rates were 56% in patients with COPD vs. 68% in those without; 52% in those with renal insufficiency vs. 73% in those without; 43% in patients undergoing nonelective repair vs. 68% in those having elective repair; 47% in patients with cardiovascular disease vs. 68% in those without; 41% in patients who sustained renal complications vs. 72% in those who did not; and 46% in patients who sustained pulmonary complications vs. 66% in those who did not, Dr. Nathan said.

Coronary artery disease was not found to predict either 30-day or 5-year survival, COPD did not predict 30-day survival, and cardiac complications did not predict 5-year survival, he noted.

Overall survival in this study of 289 men and 119 women (mean age, 72 years) who underwent open abdominal aortic aneurysm repair during the era of stent grafting was 96% at 30 days, 90% at 1 year, and 64% at 5 years.

Coronary artery disease was present in 56% of patients, renal insufficiency was present in 43%, COPD was present in 30%, and cerebrovascular disease was present in 18%. The mean aneurysm maximal diameter was 6.3 cm, and 67% of patients underwent nonelective repair.

Renal, cardiac, and pulmonary complications occurred in 19%, 17%, and 11% of patients, respectively.

Although the findings show that open AAA repair can be accomplished with low mortality, they underscore the need for careful patient selection, as well as diligent intraoperative technique and postoperative care, for optimizing results, Dr. Nathan concluded.

Dr. Nathan had no disclosures.

LAKE BUENA VISTA, FLA. – Several factors were shown to predict decreased survival following open abdominal aortic aneurysm repair, according to a retrospective study of 408 patients.

For example, the clamp site – which was infrarenal in 33.6% of patients, suprarenal in 23.8% of patients, and supraceliac in 42.6% of patients – was found on multivariate analysis to be a statistically significant predictor of 5-year survival, Dr. Derek P. Nathan reported at the annual meeting of the Society for Clinical Vascular Surgery.

The 5-year survival was 74% with infrarenal site, compared with 65% for suprarenal site and 53% for supraceliac site, said Dr. Nathan of the Hospital of the University of Pennsylvania, Philadelphia.

Other factors that were found to significantly predict survival in this study were chronic obstructive pulmonary disease, renal insufficiency, and nonelective repair, all of which were significant predictors of both 30-day and 5-year survival. Cardiovascular disease, renal complications, and pulmonary complications were significant predictors of 5-year survival.

The 30-day survival rates were 92% in patients with COPD vs. 97% in those without; 92% in patients with renal insufficiency vs. 98% in those without; and 90% in patients undergoing nonelective repair vs. 97% in those having elective repair.

The 5-year survival rates were 56% in patients with COPD vs. 68% in those without; 52% in those with renal insufficiency vs. 73% in those without; 43% in patients undergoing nonelective repair vs. 68% in those having elective repair; 47% in patients with cardiovascular disease vs. 68% in those without; 41% in patients who sustained renal complications vs. 72% in those who did not; and 46% in patients who sustained pulmonary complications vs. 66% in those who did not, Dr. Nathan said.

Coronary artery disease was not found to predict either 30-day or 5-year survival, COPD did not predict 30-day survival, and cardiac complications did not predict 5-year survival, he noted.

Overall survival in this study of 289 men and 119 women (mean age, 72 years) who underwent open abdominal aortic aneurysm repair during the era of stent grafting was 96% at 30 days, 90% at 1 year, and 64% at 5 years.

Coronary artery disease was present in 56% of patients, renal insufficiency was present in 43%, COPD was present in 30%, and cerebrovascular disease was present in 18%. The mean aneurysm maximal diameter was 6.3 cm, and 67% of patients underwent nonelective repair.

Renal, cardiac, and pulmonary complications occurred in 19%, 17%, and 11% of patients, respectively.

Although the findings show that open AAA repair can be accomplished with low mortality, they underscore the need for careful patient selection, as well as diligent intraoperative technique and postoperative care, for optimizing results, Dr. Nathan concluded.

Dr. Nathan had no disclosures.

LAKE BUENA VISTA, FLA. – Several factors were shown to predict decreased survival following open abdominal aortic aneurysm repair, according to a retrospective study of 408 patients.

For example, the clamp site – which was infrarenal in 33.6% of patients, suprarenal in 23.8% of patients, and supraceliac in 42.6% of patients – was found on multivariate analysis to be a statistically significant predictor of 5-year survival, Dr. Derek P. Nathan reported at the annual meeting of the Society for Clinical Vascular Surgery.

The 5-year survival was 74% with infrarenal site, compared with 65% for suprarenal site and 53% for supraceliac site, said Dr. Nathan of the Hospital of the University of Pennsylvania, Philadelphia.

Other factors that were found to significantly predict survival in this study were chronic obstructive pulmonary disease, renal insufficiency, and nonelective repair, all of which were significant predictors of both 30-day and 5-year survival. Cardiovascular disease, renal complications, and pulmonary complications were significant predictors of 5-year survival.

The 30-day survival rates were 92% in patients with COPD vs. 97% in those without; 92% in patients with renal insufficiency vs. 98% in those without; and 90% in patients undergoing nonelective repair vs. 97% in those having elective repair.

The 5-year survival rates were 56% in patients with COPD vs. 68% in those without; 52% in those with renal insufficiency vs. 73% in those without; 43% in patients undergoing nonelective repair vs. 68% in those having elective repair; 47% in patients with cardiovascular disease vs. 68% in those without; 41% in patients who sustained renal complications vs. 72% in those who did not; and 46% in patients who sustained pulmonary complications vs. 66% in those who did not, Dr. Nathan said.

Coronary artery disease was not found to predict either 30-day or 5-year survival, COPD did not predict 30-day survival, and cardiac complications did not predict 5-year survival, he noted.

Overall survival in this study of 289 men and 119 women (mean age, 72 years) who underwent open abdominal aortic aneurysm repair during the era of stent grafting was 96% at 30 days, 90% at 1 year, and 64% at 5 years.

Coronary artery disease was present in 56% of patients, renal insufficiency was present in 43%, COPD was present in 30%, and cerebrovascular disease was present in 18%. The mean aneurysm maximal diameter was 6.3 cm, and 67% of patients underwent nonelective repair.

Renal, cardiac, and pulmonary complications occurred in 19%, 17%, and 11% of patients, respectively.

Although the findings show that open AAA repair can be accomplished with low mortality, they underscore the need for careful patient selection, as well as diligent intraoperative technique and postoperative care, for optimizing results, Dr. Nathan concluded.

Dr. Nathan had no disclosures.

Patients with alcohol use disorders who develop health care–associated infections have a 71% greater mortality risk, as well as longer hospital stays and higher hospital costs, than do those without alcohol use disorders who develop such infections, according to an analysis of data from a large inpatient database.

Photo credit: ©James Cox/Fotolia.com

The researchers studied the more than 32.7 million hospital discharges in the Nationwide Inpatient Sample for 2007, of which 149,982 developed a health care–associated infection and met inclusion criteria for the study. From the overall group, 4.7% were patients with an alcohol use disorder (AUD), while 5.9% of the cohort with a health care–associated infection also had an AUD codiagnosis, the researchers wrote. Having an AUD was found to be an independent predictor of increased mortality in the latter group (odds ratio 1.71), Dr. Marjolein de Wit of Virginia Commonwealth University, Richmond, and her colleagues reported online April 15 in Alcoholism: Clinical and Experimental Research.

An AUD diagnosis was also found to be an independent predictor of a 2-day increase in hospital length of stay (13 days in those with an AUD vs.11 days in those without). Hospital costs were about $7,500 higher ($34,826 vs. $27,167) for those AUD patients, the investigators said (Alcohol. Clin. Exp. Res. 2011 April 15 [doi: 10.1111/j.1530-0277.2011.01475.x]).

Prior studies have shown that the increased risk of health care infections in this population might be explained by cytokine abnormalities, impaired cell-mediated immune function, and aberrant innate immunity, they noted.

"Studies evaluating therapies aimed at decreasing the risk of developing health care–associated infections in patients with AUD are warranted," they concluded.

In the meantime, steps can be taken to reduce risk of developing health care–associated infections, according to Dr. Claudia Spies, of University Hospital Charite Universitaetsmedizin Berlin, whose earlier research was cited in the current study.

In a statement on the findings, Dr. Spies stressed the importance of external measures such as hand washing and head-of-bed elevation, and of the need for intrinsic measures such as therapeutic interventions specifically targeting hospitalized patients with AUDs. AUDs are factors intrinsic to patients, and thus preventing health care–associated infections in these patients requires such interventions, she explained.

Dr. Spies, along with Dr. de Wit, also emphasized the need for candid discussion about alcohol use with patients – despite the stigma they may feel.

"This is important both when a hospital admission is scheduled as well as at the time of an emergency hospital admission. In the case with scheduled surgeries, such as an elective surgery, one month preoperative abstinence may decrease the risk of health care–associated infections," Dr. de Wit said.

Follow-up care is also a necessity, she added, noting that patients will need anonymous data handling and help finding adequate intervention and treatment for their AUD.

The Nationwide Inpatient Sample for 2007 included hospital discharge data on adults aged 18 years and older. The investigators focused on those who developed pneumonia and/or sepsis, and excluded those who transferred from another health care facility, as well as those with immune suppression, cancer, or a community-acquired infection. Pneumonia was the most common health care–associated infection, occurring in 135,267 AUD patients, while sepsis occurred in 12,046, and both pneumonia and sepsis occurred in 2,579.

Alcohol use disorder designation was "based on an ICD diagnosis and encompassed alcohol dependence syndrome, alcohol abuse, and alcohol-induced mental disorders," the researchers explained.

The greater proportion of AUD patients in the subgroup of individuals with health care–associated infections, compared with the entire cohort, was not surprising; prior studies have demonstrated that AUD is common in hospitalized patients, and that it is associated with an increased risk of health care–associated infections. In fact, some studies have demonstrated rates of AUD up to 42% in hospitalized patients. Thus, given that the rates in this study were only 4.7% in all discharged patients and 5.9% in those with health care–associated infections (likely due to underdiagnosis, according to the investigators), it is likely that the effects of AUD in these patients are actually underestimated by this study, they said.

Although the study is limited by its retrospective design and the fact that the sample used has not been validated, the sample is large and likely representative, and the results indicate that patients with an AUD are disproportionately affected when it comes to mortality, hospital stay, and hospital costs, the investigators said.

The authors reported that they had no disclosures.

Patients with alcohol use disorders who develop health care–associated infections have a 71% greater mortality risk, as well as longer hospital stays and higher hospital costs, than do those without alcohol use disorders who develop such infections, according to an analysis of data from a large inpatient database.

Photo credit: ©James Cox/Fotolia.com

The researchers studied the more than 32.7 million hospital discharges in the Nationwide Inpatient Sample for 2007, of which 149,982 developed a health care–associated infection and met inclusion criteria for the study. From the overall group, 4.7% were patients with an alcohol use disorder (AUD), while 5.9% of the cohort with a health care–associated infection also had an AUD codiagnosis, the researchers wrote. Having an AUD was found to be an independent predictor of increased mortality in the latter group (odds ratio 1.71), Dr. Marjolein de Wit of Virginia Commonwealth University, Richmond, and her colleagues reported online April 15 in Alcoholism: Clinical and Experimental Research.

An AUD diagnosis was also found to be an independent predictor of a 2-day increase in hospital length of stay (13 days in those with an AUD vs.11 days in those without). Hospital costs were about $7,500 higher ($34,826 vs. $27,167) for those AUD patients, the investigators said (Alcohol. Clin. Exp. Res. 2011 April 15 [doi: 10.1111/j.1530-0277.2011.01475.x]).

Prior studies have shown that the increased risk of health care infections in this population might be explained by cytokine abnormalities, impaired cell-mediated immune function, and aberrant innate immunity, they noted.

"Studies evaluating therapies aimed at decreasing the risk of developing health care–associated infections in patients with AUD are warranted," they concluded.

In the meantime, steps can be taken to reduce risk of developing health care–associated infections, according to Dr. Claudia Spies, of University Hospital Charite Universitaetsmedizin Berlin, whose earlier research was cited in the current study.

In a statement on the findings, Dr. Spies stressed the importance of external measures such as hand washing and head-of-bed elevation, and of the need for intrinsic measures such as therapeutic interventions specifically targeting hospitalized patients with AUDs. AUDs are factors intrinsic to patients, and thus preventing health care–associated infections in these patients requires such interventions, she explained.

Dr. Spies, along with Dr. de Wit, also emphasized the need for candid discussion about alcohol use with patients – despite the stigma they may feel.

"This is important both when a hospital admission is scheduled as well as at the time of an emergency hospital admission. In the case with scheduled surgeries, such as an elective surgery, one month preoperative abstinence may decrease the risk of health care–associated infections," Dr. de Wit said.

Follow-up care is also a necessity, she added, noting that patients will need anonymous data handling and help finding adequate intervention and treatment for their AUD.

The Nationwide Inpatient Sample for 2007 included hospital discharge data on adults aged 18 years and older. The investigators focused on those who developed pneumonia and/or sepsis, and excluded those who transferred from another health care facility, as well as those with immune suppression, cancer, or a community-acquired infection. Pneumonia was the most common health care–associated infection, occurring in 135,267 AUD patients, while sepsis occurred in 12,046, and both pneumonia and sepsis occurred in 2,579.

Alcohol use disorder designation was "based on an ICD diagnosis and encompassed alcohol dependence syndrome, alcohol abuse, and alcohol-induced mental disorders," the researchers explained.

The greater proportion of AUD patients in the subgroup of individuals with health care–associated infections, compared with the entire cohort, was not surprising; prior studies have demonstrated that AUD is common in hospitalized patients, and that it is associated with an increased risk of health care–associated infections. In fact, some studies have demonstrated rates of AUD up to 42% in hospitalized patients. Thus, given that the rates in this study were only 4.7% in all discharged patients and 5.9% in those with health care–associated infections (likely due to underdiagnosis, according to the investigators), it is likely that the effects of AUD in these patients are actually underestimated by this study, they said.

Although the study is limited by its retrospective design and the fact that the sample used has not been validated, the sample is large and likely representative, and the results indicate that patients with an AUD are disproportionately affected when it comes to mortality, hospital stay, and hospital costs, the investigators said.

The authors reported that they had no disclosures.

Patients with alcohol use disorders who develop health care–associated infections have a 71% greater mortality risk, as well as longer hospital stays and higher hospital costs, than do those without alcohol use disorders who develop such infections, according to an analysis of data from a large inpatient database.

Photo credit: ©James Cox/Fotolia.com

The researchers studied the more than 32.7 million hospital discharges in the Nationwide Inpatient Sample for 2007, of which 149,982 developed a health care–associated infection and met inclusion criteria for the study. From the overall group, 4.7% were patients with an alcohol use disorder (AUD), while 5.9% of the cohort with a health care–associated infection also had an AUD codiagnosis, the researchers wrote. Having an AUD was found to be an independent predictor of increased mortality in the latter group (odds ratio 1.71), Dr. Marjolein de Wit of Virginia Commonwealth University, Richmond, and her colleagues reported online April 15 in Alcoholism: Clinical and Experimental Research.

An AUD diagnosis was also found to be an independent predictor of a 2-day increase in hospital length of stay (13 days in those with an AUD vs.11 days in those without). Hospital costs were about $7,500 higher ($34,826 vs. $27,167) for those AUD patients, the investigators said (Alcohol. Clin. Exp. Res. 2011 April 15 [doi: 10.1111/j.1530-0277.2011.01475.x]).

Prior studies have shown that the increased risk of health care infections in this population might be explained by cytokine abnormalities, impaired cell-mediated immune function, and aberrant innate immunity, they noted.

"Studies evaluating therapies aimed at decreasing the risk of developing health care–associated infections in patients with AUD are warranted," they concluded.

In the meantime, steps can be taken to reduce risk of developing health care–associated infections, according to Dr. Claudia Spies, of University Hospital Charite Universitaetsmedizin Berlin, whose earlier research was cited in the current study.

In a statement on the findings, Dr. Spies stressed the importance of external measures such as hand washing and head-of-bed elevation, and of the need for intrinsic measures such as therapeutic interventions specifically targeting hospitalized patients with AUDs. AUDs are factors intrinsic to patients, and thus preventing health care–associated infections in these patients requires such interventions, she explained.

Dr. Spies, along with Dr. de Wit, also emphasized the need for candid discussion about alcohol use with patients – despite the stigma they may feel.

"This is important both when a hospital admission is scheduled as well as at the time of an emergency hospital admission. In the case with scheduled surgeries, such as an elective surgery, one month preoperative abstinence may decrease the risk of health care–associated infections," Dr. de Wit said.

Follow-up care is also a necessity, she added, noting that patients will need anonymous data handling and help finding adequate intervention and treatment for their AUD.

The Nationwide Inpatient Sample for 2007 included hospital discharge data on adults aged 18 years and older. The investigators focused on those who developed pneumonia and/or sepsis, and excluded those who transferred from another health care facility, as well as those with immune suppression, cancer, or a community-acquired infection. Pneumonia was the most common health care–associated infection, occurring in 135,267 AUD patients, while sepsis occurred in 12,046, and both pneumonia and sepsis occurred in 2,579.

Alcohol use disorder designation was "based on an ICD diagnosis and encompassed alcohol dependence syndrome, alcohol abuse, and alcohol-induced mental disorders," the researchers explained.

The greater proportion of AUD patients in the subgroup of individuals with health care–associated infections, compared with the entire cohort, was not surprising; prior studies have demonstrated that AUD is common in hospitalized patients, and that it is associated with an increased risk of health care–associated infections. In fact, some studies have demonstrated rates of AUD up to 42% in hospitalized patients. Thus, given that the rates in this study were only 4.7% in all discharged patients and 5.9% in those with health care–associated infections (likely due to underdiagnosis, according to the investigators), it is likely that the effects of AUD in these patients are actually underestimated by this study, they said.

Although the study is limited by its retrospective design and the fact that the sample used has not been validated, the sample is large and likely representative, and the results indicate that patients with an AUD are disproportionately affected when it comes to mortality, hospital stay, and hospital costs, the investigators said.

The authors reported that they had no disclosures.

Patients with alcohol use disorders who develop health care–associated infections have a 71% greater mortality risk, as well as longer hospital stays and higher hospital costs, than do those without alcohol use disorders who develop such infections, according to an analysis of data from a large inpatient database.

Photo credit: ©James Cox/Fotolia.com

The researchers studied the more than 32.7 million hospital discharges in the Nationwide Inpatient Sample for 2007, of which 149,982 developed a health care–associated infection and met inclusion criteria for the study. From the overall group, 4.7% were patients with an alcohol use disorder (AUD), while 5.9% of the cohort with a health care–associated infection also had an AUD codiagnosis, the researchers wrote. Having an AUD was found to be an independent predictor of increased mortality in the latter group (odds ratio 1.71), Dr. Marjolein de Wit of Virginia Commonwealth University, Richmond, and her colleagues reported online April 15 in Alcoholism: Clinical and Experimental Research.

An AUD diagnosis was also found to be an independent predictor of a 2-day increase in hospital length of stay (13 days in those with an AUD vs.11 days in those without). Hospital costs were about $7,500 higher ($34,826 vs. $27,167) for those AUD patients, the investigators said (Alcohol. Clin. Exp. Res. 2011 April 15 [doi: 10.1111/j.1530-0277.2011.01475.x]).

Prior studies have shown that the increased risk of health care infections in this population might be explained by cytokine abnormalities, impaired cell-mediated immune function, and aberrant innate immunity, they noted.

"Studies evaluating therapies aimed at decreasing the risk of developing health care–associated infections in patients with AUD are warranted," they concluded.

In the meantime, steps can be taken to reduce risk of developing health care–associated infections, according to Dr. Claudia Spies, of University Hospital Charite Universitaetsmedizin Berlin, whose earlier research was cited in the current study.

In a statement on the findings, Dr. Spies stressed the importance of external measures such as hand washing and head-of-bed elevation, and of the need for intrinsic measures such as therapeutic interventions specifically targeting hospitalized patients with AUDs. AUDs are factors intrinsic to patients, and thus preventing health care–associated infections in these patients requires such interventions, she explained.

Dr. Spies, along with Dr. de Wit, also emphasized the need for candid discussion about alcohol use with patients – despite the stigma they may feel.

"This is important both when a hospital admission is scheduled as well as at the time of an emergency hospital admission. In the case with scheduled surgeries, such as an elective surgery, one month preoperative abstinence may decrease the risk of health care–associated infections," Dr. de Wit said.

Follow-up care is also a necessity, she added, noting that patients will need anonymous data handling and help finding adequate intervention and treatment for their AUD.

The Nationwide Inpatient Sample for 2007 included hospital discharge data on adults aged 18 years and older. The investigators focused on those who developed pneumonia and/or sepsis, and excluded those who transferred from another health care facility, as well as those with immune suppression, cancer, or a community-acquired infection. Pneumonia was the most common health care–associated infection, occurring in 135,267 AUD patients, while sepsis occurred in 12,046, and both pneumonia and sepsis occurred in 2,579.

Alcohol use disorder designation was "based on an ICD diagnosis and encompassed alcohol dependence syndrome, alcohol abuse, and alcohol-induced mental disorders," the researchers explained.

The greater proportion of AUD patients in the subgroup of individuals with health care–associated infections, compared with the entire cohort, was not surprising; prior studies have demonstrated that AUD is common in hospitalized patients, and that it is associated with an increased risk of health care–associated infections. In fact, some studies have demonstrated rates of AUD up to 42% in hospitalized patients. Thus, given that the rates in this study were only 4.7% in all discharged patients and 5.9% in those with health care–associated infections (likely due to underdiagnosis, according to the investigators), it is likely that the effects of AUD in these patients are actually underestimated by this study, they said.

Although the study is limited by its retrospective design and the fact that the sample used has not been validated, the sample is large and likely representative, and the results indicate that patients with an AUD are disproportionately affected when it comes to mortality, hospital stay, and hospital costs, the investigators said.

The authors reported that they had no disclosures.

Patients with alcohol use disorders who develop health care–associated infections have a 71% greater mortality risk, as well as longer hospital stays and higher hospital costs, than do those without alcohol use disorders who develop such infections, according to an analysis of data from a large inpatient database.

Photo credit: ©James Cox/Fotolia.com

The researchers studied the more than 32.7 million hospital discharges in the Nationwide Inpatient Sample for 2007, of which 149,982 developed a health care–associated infection and met inclusion criteria for the study. From the overall group, 4.7% were patients with an alcohol use disorder (AUD), while 5.9% of the cohort with a health care–associated infection also had an AUD codiagnosis, the researchers wrote. Having an AUD was found to be an independent predictor of increased mortality in the latter group (odds ratio 1.71), Dr. Marjolein de Wit of Virginia Commonwealth University, Richmond, and her colleagues reported online April 15 in Alcoholism: Clinical and Experimental Research.

An AUD diagnosis was also found to be an independent predictor of a 2-day increase in hospital length of stay (13 days in those with an AUD vs.11 days in those without). Hospital costs were about $7,500 higher ($34,826 vs. $27,167) for those AUD patients, the investigators said (Alcohol. Clin. Exp. Res. 2011 April 15 [doi: 10.1111/j.1530-0277.2011.01475.x]).

Prior studies have shown that the increased risk of health care infections in this population might be explained by cytokine abnormalities, impaired cell-mediated immune function, and aberrant innate immunity, they noted.

"Studies evaluating therapies aimed at decreasing the risk of developing health care–associated infections in patients with AUD are warranted," they concluded.

In the meantime, steps can be taken to reduce risk of developing health care–associated infections, according to Dr. Claudia Spies, of University Hospital Charite Universitaetsmedizin Berlin, whose earlier research was cited in the current study.

In a statement on the findings, Dr. Spies stressed the importance of external measures such as hand washing and head-of-bed elevation, and of the need for intrinsic measures such as therapeutic interventions specifically targeting hospitalized patients with AUDs. AUDs are factors intrinsic to patients, and thus preventing health care–associated infections in these patients requires such interventions, she explained.

Dr. Spies, along with Dr. de Wit, also emphasized the need for candid discussion about alcohol use with patients – despite the stigma they may feel.

"This is important both when a hospital admission is scheduled as well as at the time of an emergency hospital admission. In the case with scheduled surgeries, such as an elective surgery, one month preoperative abstinence may decrease the risk of health care–associated infections," Dr. de Wit said.

Follow-up care is also a necessity, she added, noting that patients will need anonymous data handling and help finding adequate intervention and treatment for their AUD.

The Nationwide Inpatient Sample for 2007 included hospital discharge data on adults aged 18 years and older. The investigators focused on those who developed pneumonia and/or sepsis, and excluded those who transferred from another health care facility, as well as those with immune suppression, cancer, or a community-acquired infection. Pneumonia was the most common health care–associated infection, occurring in 135,267 AUD patients, while sepsis occurred in 12,046, and both pneumonia and sepsis occurred in 2,579.

Alcohol use disorder designation was "based on an ICD diagnosis and encompassed alcohol dependence syndrome, alcohol abuse, and alcohol-induced mental disorders," the researchers explained.

The greater proportion of AUD patients in the subgroup of individuals with health care–associated infections, compared with the entire cohort, was not surprising; prior studies have demonstrated that AUD is common in hospitalized patients, and that it is associated with an increased risk of health care–associated infections. In fact, some studies have demonstrated rates of AUD up to 42% in hospitalized patients. Thus, given that the rates in this study were only 4.7% in all discharged patients and 5.9% in those with health care–associated infections (likely due to underdiagnosis, according to the investigators), it is likely that the effects of AUD in these patients are actually underestimated by this study, they said.

Although the study is limited by its retrospective design and the fact that the sample used has not been validated, the sample is large and likely representative, and the results indicate that patients with an AUD are disproportionately affected when it comes to mortality, hospital stay, and hospital costs, the investigators said.

The authors reported that they had no disclosures.

Patients with alcohol use disorders who develop health care–associated infections have a 71% greater mortality risk, as well as longer hospital stays and higher hospital costs, than do those without alcohol use disorders who develop such infections, according to an analysis of data from a large inpatient database.

Photo credit: ©James Cox/Fotolia.com

The researchers studied the more than 32.7 million hospital discharges in the Nationwide Inpatient Sample for 2007, of which 149,982 developed a health care–associated infection and met inclusion criteria for the study. From the overall group, 4.7% were patients with an alcohol use disorder (AUD), while 5.9% of the cohort with a health care–associated infection also had an AUD codiagnosis, the researchers wrote. Having an AUD was found to be an independent predictor of increased mortality in the latter group (odds ratio 1.71), Dr. Marjolein de Wit of Virginia Commonwealth University, Richmond, and her colleagues reported online April 15 in Alcoholism: Clinical and Experimental Research.

An AUD diagnosis was also found to be an independent predictor of a 2-day increase in hospital length of stay (13 days in those with an AUD vs.11 days in those without). Hospital costs were about $7,500 higher ($34,826 vs. $27,167) for those AUD patients, the investigators said (Alcohol. Clin. Exp. Res. 2011 April 15 [doi: 10.1111/j.1530-0277.2011.01475.x]).

Prior studies have shown that the increased risk of health care infections in this population might be explained by cytokine abnormalities, impaired cell-mediated immune function, and aberrant innate immunity, they noted.

"Studies evaluating therapies aimed at decreasing the risk of developing health care–associated infections in patients with AUD are warranted," they concluded.

In the meantime, steps can be taken to reduce risk of developing health care–associated infections, according to Dr. Claudia Spies, of University Hospital Charite Universitaetsmedizin Berlin, whose earlier research was cited in the current study.

In a statement on the findings, Dr. Spies stressed the importance of external measures such as hand washing and head-of-bed elevation, and of the need for intrinsic measures such as therapeutic interventions specifically targeting hospitalized patients with AUDs. AUDs are factors intrinsic to patients, and thus preventing health care–associated infections in these patients requires such interventions, she explained.

Dr. Spies, along with Dr. de Wit, also emphasized the need for candid discussion about alcohol use with patients – despite the stigma they may feel.

"This is important both when a hospital admission is scheduled as well as at the time of an emergency hospital admission. In the case with scheduled surgeries, such as an elective surgery, one month preoperative abstinence may decrease the risk of health care–associated infections," Dr. de Wit said.

Follow-up care is also a necessity, she added, noting that patients will need anonymous data handling and help finding adequate intervention and treatment for their AUD.

The Nationwide Inpatient Sample for 2007 included hospital discharge data on adults aged 18 years and older. The investigators focused on those who developed pneumonia and/or sepsis, and excluded those who transferred from another health care facility, as well as those with immune suppression, cancer, or a community-acquired infection. Pneumonia was the most common health care–associated infection, occurring in 135,267 AUD patients, while sepsis occurred in 12,046, and both pneumonia and sepsis occurred in 2,579.

Alcohol use disorder designation was "based on an ICD diagnosis and encompassed alcohol dependence syndrome, alcohol abuse, and alcohol-induced mental disorders," the researchers explained.

The greater proportion of AUD patients in the subgroup of individuals with health care–associated infections, compared with the entire cohort, was not surprising; prior studies have demonstrated that AUD is common in hospitalized patients, and that it is associated with an increased risk of health care–associated infections. In fact, some studies have demonstrated rates of AUD up to 42% in hospitalized patients. Thus, given that the rates in this study were only 4.7% in all discharged patients and 5.9% in those with health care–associated infections (likely due to underdiagnosis, according to the investigators), it is likely that the effects of AUD in these patients are actually underestimated by this study, they said.

Although the study is limited by its retrospective design and the fact that the sample used has not been validated, the sample is large and likely representative, and the results indicate that patients with an AUD are disproportionately affected when it comes to mortality, hospital stay, and hospital costs, the investigators said.

The authors reported that they had no disclosures.

Patients with alcohol use disorders who develop health care–associated infections have a 71% greater mortality risk, as well as longer hospital stays and higher hospital costs, than do those without alcohol use disorders who develop such infections, according to an analysis of data from a large inpatient database.

Photo credit: ©James Cox/Fotolia.com

The researchers studied the more than 32.7 million hospital discharges in the Nationwide Inpatient Sample for 2007, of which 149,982 developed a health care–associated infection and met inclusion criteria for the study. From the overall group, 4.7% were patients with an alcohol use disorder (AUD), while 5.9% of the cohort with a health care–associated infection also had an AUD codiagnosis, the researchers wrote. Having an AUD was found to be an independent predictor of increased mortality in the latter group (odds ratio 1.71), Dr. Marjolein de Wit of Virginia Commonwealth University, Richmond, and her colleagues reported online April 15 in Alcoholism: Clinical and Experimental Research.

An AUD diagnosis was also found to be an independent predictor of a 2-day increase in hospital length of stay (13 days in those with an AUD vs.11 days in those without). Hospital costs were about $7,500 higher ($34,826 vs. $27,167) for those AUD patients, the investigators said (Alcohol. Clin. Exp. Res. 2011 April 15 [doi: 10.1111/j.1530-0277.2011.01475.x]).

Prior studies have shown that the increased risk of health care infections in this population might be explained by cytokine abnormalities, impaired cell-mediated immune function, and aberrant innate immunity, they noted.

"Studies evaluating therapies aimed at decreasing the risk of developing health care–associated infections in patients with AUD are warranted," they concluded.

In the meantime, steps can be taken to reduce risk of developing health care–associated infections, according to Dr. Claudia Spies, of University Hospital Charite Universitaetsmedizin Berlin, whose earlier research was cited in the current study.

In a statement on the findings, Dr. Spies stressed the importance of external measures such as hand washing and head-of-bed elevation, and of the need for intrinsic measures such as therapeutic interventions specifically targeting hospitalized patients with AUDs. AUDs are factors intrinsic to patients, and thus preventing health care–associated infections in these patients requires such interventions, she explained.

Dr. Spies, along with Dr. de Wit, also emphasized the need for candid discussion about alcohol use with patients – despite the stigma they may feel.

"This is important both when a hospital admission is scheduled as well as at the time of an emergency hospital admission. In the case with scheduled surgeries, such as an elective surgery, one month preoperative abstinence may decrease the risk of health care–associated infections," Dr. de Wit said.

Follow-up care is also a necessity, she added, noting that patients will need anonymous data handling and help finding adequate intervention and treatment for their AUD.

The Nationwide Inpatient Sample for 2007 included hospital discharge data on adults aged 18 years and older. The investigators focused on those who developed pneumonia and/or sepsis, and excluded those who transferred from another health care facility, as well as those with immune suppression, cancer, or a community-acquired infection. Pneumonia was the most common health care–associated infection, occurring in 135,267 AUD patients, while sepsis occurred in 12,046, and both pneumonia and sepsis occurred in 2,579.

Alcohol use disorder designation was "based on an ICD diagnosis and encompassed alcohol dependence syndrome, alcohol abuse, and alcohol-induced mental disorders," the researchers explained.

The greater proportion of AUD patients in the subgroup of individuals with health care–associated infections, compared with the entire cohort, was not surprising; prior studies have demonstrated that AUD is common in hospitalized patients, and that it is associated with an increased risk of health care–associated infections. In fact, some studies have demonstrated rates of AUD up to 42% in hospitalized patients. Thus, given that the rates in this study were only 4.7% in all discharged patients and 5.9% in those with health care–associated infections (likely due to underdiagnosis, according to the investigators), it is likely that the effects of AUD in these patients are actually underestimated by this study, they said.

Although the study is limited by its retrospective design and the fact that the sample used has not been validated, the sample is large and likely representative, and the results indicate that patients with an AUD are disproportionately affected when it comes to mortality, hospital stay, and hospital costs, the investigators said.

The authors reported that they had no disclosures.

Patients with alcohol use disorders who develop health care–associated infections have a 71% greater mortality risk, as well as longer hospital stays and higher hospital costs, than do those without alcohol use disorders who develop such infections, according to an analysis of data from a large inpatient database.

Photo credit: ©James Cox/Fotolia.com

The researchers studied the more than 32.7 million hospital discharges in the Nationwide Inpatient Sample for 2007, of which 149,982 developed a health care–associated infection and met inclusion criteria for the study. From the overall group, 4.7% were patients with an alcohol use disorder (AUD), while 5.9% of the cohort with a health care–associated infection also had an AUD codiagnosis, the researchers wrote. Having an AUD was found to be an independent predictor of increased mortality in the latter group (odds ratio 1.71), Dr. Marjolein de Wit of Virginia Commonwealth University, Richmond, and her colleagues reported online April 15 in Alcoholism: Clinical and Experimental Research.

An AUD diagnosis was also found to be an independent predictor of a 2-day increase in hospital length of stay (13 days in those with an AUD vs.11 days in those without). Hospital costs were about $7,500 higher ($34,826 vs. $27,167) for those AUD patients, the investigators said (Alcohol. Clin. Exp. Res. 2011 April 15 [doi: 10.1111/j.1530-0277.2011.01475.x]).

Prior studies have shown that the increased risk of health care infections in this population might be explained by cytokine abnormalities, impaired cell-mediated immune function, and aberrant innate immunity, they noted.

"Studies evaluating therapies aimed at decreasing the risk of developing health care–associated infections in patients with AUD are warranted," they concluded.

In the meantime, steps can be taken to reduce risk of developing health care–associated infections, according to Dr. Claudia Spies, of University Hospital Charite Universitaetsmedizin Berlin, whose earlier research was cited in the current study.

In a statement on the findings, Dr. Spies stressed the importance of external measures such as hand washing and head-of-bed elevation, and of the need for intrinsic measures such as therapeutic interventions specifically targeting hospitalized patients with AUDs. AUDs are factors intrinsic to patients, and thus preventing health care–associated infections in these patients requires such interventions, she explained.

Dr. Spies, along with Dr. de Wit, also emphasized the need for candid discussion about alcohol use with patients – despite the stigma they may feel.

"This is important both when a hospital admission is scheduled as well as at the time of an emergency hospital admission. In the case with scheduled surgeries, such as an elective surgery, one month preoperative abstinence may decrease the risk of health care–associated infections," Dr. de Wit said.

Follow-up care is also a necessity, she added, noting that patients will need anonymous data handling and help finding adequate intervention and treatment for their AUD.

The Nationwide Inpatient Sample for 2007 included hospital discharge data on adults aged 18 years and older. The investigators focused on those who developed pneumonia and/or sepsis, and excluded those who transferred from another health care facility, as well as those with immune suppression, cancer, or a community-acquired infection. Pneumonia was the most common health care–associated infection, occurring in 135,267 AUD patients, while sepsis occurred in 12,046, and both pneumonia and sepsis occurred in 2,579.

Alcohol use disorder designation was "based on an ICD diagnosis and encompassed alcohol dependence syndrome, alcohol abuse, and alcohol-induced mental disorders," the researchers explained.

The greater proportion of AUD patients in the subgroup of individuals with health care–associated infections, compared with the entire cohort, was not surprising; prior studies have demonstrated that AUD is common in hospitalized patients, and that it is associated with an increased risk of health care–associated infections. In fact, some studies have demonstrated rates of AUD up to 42% in hospitalized patients. Thus, given that the rates in this study were only 4.7% in all discharged patients and 5.9% in those with health care–associated infections (likely due to underdiagnosis, according to the investigators), it is likely that the effects of AUD in these patients are actually underestimated by this study, they said.

Although the study is limited by its retrospective design and the fact that the sample used has not been validated, the sample is large and likely representative, and the results indicate that patients with an AUD are disproportionately affected when it comes to mortality, hospital stay, and hospital costs, the investigators said.

The authors reported that they had no disclosures.

Patients with alcohol use disorders who develop health care–associated infections have a 71% greater mortality risk, as well as longer hospital stays and higher hospital costs, than do those without alcohol use disorders who develop such infections, according to an analysis of data from a large inpatient database.

Photo credit: ©James Cox/Fotolia.com

The researchers studied the more than 32.7 million hospital discharges in the Nationwide Inpatient Sample for 2007, of which 149,982 developed a health care–associated infection and met inclusion criteria for the study. From the overall group, 4.7% were patients with an alcohol use disorder (AUD), while 5.9% of the cohort with a health care–associated infection also had an AUD codiagnosis, the researchers wrote. Having an AUD was found to be an independent predictor of increased mortality in the latter group (odds ratio 1.71), Dr. Marjolein de Wit of Virginia Commonwealth University, Richmond, and her colleagues reported online April 15 in Alcoholism: Clinical and Experimental Research.

An AUD diagnosis was also found to be an independent predictor of a 2-day increase in hospital length of stay (13 days in those with an AUD vs.11 days in those without). Hospital costs were about $7,500 higher ($34,826 vs. $27,167) for those AUD patients, the investigators said (Alcohol. Clin. Exp. Res. 2011 April 15 [doi: 10.1111/j.1530-0277.2011.01475.x]).

Prior studies have shown that the increased risk of health care infections in this population might be explained by cytokine abnormalities, impaired cell-mediated immune function, and aberrant innate immunity, they noted.

"Studies evaluating therapies aimed at decreasing the risk of developing health care–associated infections in patients with AUD are warranted," they concluded.

In the meantime, steps can be taken to reduce risk of developing health care–associated infections, according to Dr. Claudia Spies, of University Hospital Charite Universitaetsmedizin Berlin, whose earlier research was cited in the current study.

In a statement on the findings, Dr. Spies stressed the importance of external measures such as hand washing and head-of-bed elevation, and of the need for intrinsic measures such as therapeutic interventions specifically targeting hospitalized patients with AUDs. AUDs are factors intrinsic to patients, and thus preventing health care–associated infections in these patients requires such interventions, she explained.

Dr. Spies, along with Dr. de Wit, also emphasized the need for candid discussion about alcohol use with patients – despite the stigma they may feel.

"This is important both when a hospital admission is scheduled as well as at the time of an emergency hospital admission. In the case with scheduled surgeries, such as an elective surgery, one month preoperative abstinence may decrease the risk of health care–associated infections," Dr. de Wit said.

Follow-up care is also a necessity, she added, noting that patients will need anonymous data handling and help finding adequate intervention and treatment for their AUD.

The Nationwide Inpatient Sample for 2007 included hospital discharge data on adults aged 18 years and older. The investigators focused on those who developed pneumonia and/or sepsis, and excluded those who transferred from another health care facility, as well as those with immune suppression, cancer, or a community-acquired infection. Pneumonia was the most common health care–associated infection, occurring in 135,267 AUD patients, while sepsis occurred in 12,046, and both pneumonia and sepsis occurred in 2,579.

Alcohol use disorder designation was "based on an ICD diagnosis and encompassed alcohol dependence syndrome, alcohol abuse, and alcohol-induced mental disorders," the researchers explained.

The greater proportion of AUD patients in the subgroup of individuals with health care–associated infections, compared with the entire cohort, was not surprising; prior studies have demonstrated that AUD is common in hospitalized patients, and that it is associated with an increased risk of health care–associated infections. In fact, some studies have demonstrated rates of AUD up to 42% in hospitalized patients. Thus, given that the rates in this study were only 4.7% in all discharged patients and 5.9% in those with health care–associated infections (likely due to underdiagnosis, according to the investigators), it is likely that the effects of AUD in these patients are actually underestimated by this study, they said.

Although the study is limited by its retrospective design and the fact that the sample used has not been validated, the sample is large and likely representative, and the results indicate that patients with an AUD are disproportionately affected when it comes to mortality, hospital stay, and hospital costs, the investigators said.

The authors reported that they had no disclosures.

Patients with alcohol use disorders who develop health care–associated infections have a 71% greater mortality risk, as well as longer hospital stays and higher hospital costs, than do those without alcohol use disorders who develop such infections, according to an analysis of data from a large inpatient database.

Photo credit: ©James Cox/Fotolia.com

The researchers studied the more than 32.7 million hospital discharges in the Nationwide Inpatient Sample for 2007, of which 149,982 developed a health care–associated infection and met inclusion criteria for the study. From the overall group, 4.7% were patients with an alcohol use disorder (AUD), while 5.9% of the cohort with a health care–associated infection also had an AUD codiagnosis, the researchers wrote. Having an AUD was found to be an independent predictor of increased mortality in the latter group (odds ratio 1.71), Dr. Marjolein de Wit of Virginia Commonwealth University, Richmond, and her colleagues reported online April 15 in Alcoholism: Clinical and Experimental Research.

An AUD diagnosis was also found to be an independent predictor of a 2-day increase in hospital length of stay (13 days in those with an AUD vs.11 days in those without). Hospital costs were about $7,500 higher ($34,826 vs. $27,167) for those AUD patients, the investigators said (Alcohol. Clin. Exp. Res. 2011 April 15 [doi: 10.1111/j.1530-0277.2011.01475.x]).

Prior studies have shown that the increased risk of health care infections in this population might be explained by cytokine abnormalities, impaired cell-mediated immune function, and aberrant innate immunity, they noted.

"Studies evaluating therapies aimed at decreasing the risk of developing health care–associated infections in patients with AUD are warranted," they concluded.

In the meantime, steps can be taken to reduce risk of developing health care–associated infections, according to Dr. Claudia Spies, of University Hospital Charite Universitaetsmedizin Berlin, whose earlier research was cited in the current study.

In a statement on the findings, Dr. Spies stressed the importance of external measures such as hand washing and head-of-bed elevation, and of the need for intrinsic measures such as therapeutic interventions specifically targeting hospitalized patients with AUDs. AUDs are factors intrinsic to patients, and thus preventing health care–associated infections in these patients requires such interventions, she explained.

Dr. Spies, along with Dr. de Wit, also emphasized the need for candid discussion about alcohol use with patients – despite the stigma they may feel.

"This is important both when a hospital admission is scheduled as well as at the time of an emergency hospital admission. In the case with scheduled surgeries, such as an elective surgery, one month preoperative abstinence may decrease the risk of health care–associated infections," Dr. de Wit said.

Follow-up care is also a necessity, she added, noting that patients will need anonymous data handling and help finding adequate intervention and treatment for their AUD.

The Nationwide Inpatient Sample for 2007 included hospital discharge data on adults aged 18 years and older. The investigators focused on those who developed pneumonia and/or sepsis, and excluded those who transferred from another health care facility, as well as those with immune suppression, cancer, or a community-acquired infection. Pneumonia was the most common health care–associated infection, occurring in 135,267 AUD patients, while sepsis occurred in 12,046, and both pneumonia and sepsis occurred in 2,579.

Alcohol use disorder designation was "based on an ICD diagnosis and encompassed alcohol dependence syndrome, alcohol abuse, and alcohol-induced mental disorders," the researchers explained.

The greater proportion of AUD patients in the subgroup of individuals with health care–associated infections, compared with the entire cohort, was not surprising; prior studies have demonstrated that AUD is common in hospitalized patients, and that it is associated with an increased risk of health care–associated infections. In fact, some studies have demonstrated rates of AUD up to 42% in hospitalized patients. Thus, given that the rates in this study were only 4.7% in all discharged patients and 5.9% in those with health care–associated infections (likely due to underdiagnosis, according to the investigators), it is likely that the effects of AUD in these patients are actually underestimated by this study, they said.

Although the study is limited by its retrospective design and the fact that the sample used has not been validated, the sample is large and likely representative, and the results indicate that patients with an AUD are disproportionately affected when it comes to mortality, hospital stay, and hospital costs, the investigators said.

The authors reported that they had no disclosures.

Patients with alcohol use disorders who develop health care–associated infections have a 71% greater mortality risk, as well as longer hospital stays and higher hospital costs, than do those without alcohol use disorders who develop such infections, according to an analysis of data from a large inpatient database.

Photo credit: ©James Cox/Fotolia.com

The researchers studied the more than 32.7 million hospital discharges in the Nationwide Inpatient Sample for 2007, of which 149,982 developed a health care–associated infection and met inclusion criteria for the study. From the overall group, 4.7% were patients with an alcohol use disorder (AUD), while 5.9% of the cohort with a health care–associated infection also had an AUD codiagnosis, the researchers wrote. Having an AUD was found to be an independent predictor of increased mortality in the latter group (odds ratio 1.71), Dr. Marjolein de Wit of Virginia Commonwealth University, Richmond, and her colleagues reported online April 15 in Alcoholism: Clinical and Experimental Research.

An AUD diagnosis was also found to be an independent predictor of a 2-day increase in hospital length of stay (13 days in those with an AUD vs.11 days in those without). Hospital costs were about $7,500 higher ($34,826 vs. $27,167) for those AUD patients, the investigators said (Alcohol. Clin. Exp. Res. 2011 April 15 [doi: 10.1111/j.1530-0277.2011.01475.x]).

Prior studies have shown that the increased risk of health care infections in this population might be explained by cytokine abnormalities, impaired cell-mediated immune function, and aberrant innate immunity, they noted.

"Studies evaluating therapies aimed at decreasing the risk of developing health care–associated infections in patients with AUD are warranted," they concluded.

In the meantime, steps can be taken to reduce risk of developing health care–associated infections, according to Dr. Claudia Spies, of University Hospital Charite Universitaetsmedizin Berlin, whose earlier research was cited in the current study.

In a statement on the findings, Dr. Spies stressed the importance of external measures such as hand washing and head-of-bed elevation, and of the need for intrinsic measures such as therapeutic interventions specifically targeting hospitalized patients with AUDs. AUDs are factors intrinsic to patients, and thus preventing health care–associated infections in these patients requires such interventions, she explained.

Dr. Spies, along with Dr. de Wit, also emphasized the need for candid discussion about alcohol use with patients – despite the stigma they may feel.

"This is important both when a hospital admission is scheduled as well as at the time of an emergency hospital admission. In the case with scheduled surgeries, such as an elective surgery, one month preoperative abstinence may decrease the risk of health care–associated infections," Dr. de Wit said.

Follow-up care is also a necessity, she added, noting that patients will need anonymous data handling and help finding adequate intervention and treatment for their AUD.

The Nationwide Inpatient Sample for 2007 included hospital discharge data on adults aged 18 years and older. The investigators focused on those who developed pneumonia and/or sepsis, and excluded those who transferred from another health care facility, as well as those with immune suppression, cancer, or a community-acquired infection. Pneumonia was the most common health care–associated infection, occurring in 135,267 AUD patients, while sepsis occurred in 12,046, and both pneumonia and sepsis occurred in 2,579.

Alcohol use disorder designation was "based on an ICD diagnosis and encompassed alcohol dependence syndrome, alcohol abuse, and alcohol-induced mental disorders," the researchers explained.

The greater proportion of AUD patients in the subgroup of individuals with health care–associated infections, compared with the entire cohort, was not surprising; prior studies have demonstrated that AUD is common in hospitalized patients, and that it is associated with an increased risk of health care–associated infections. In fact, some studies have demonstrated rates of AUD up to 42% in hospitalized patients. Thus, given that the rates in this study were only 4.7% in all discharged patients and 5.9% in those with health care–associated infections (likely due to underdiagnosis, according to the investigators), it is likely that the effects of AUD in these patients are actually underestimated by this study, they said.

Although the study is limited by its retrospective design and the fact that the sample used has not been validated, the sample is large and likely representative, and the results indicate that patients with an AUD are disproportionately affected when it comes to mortality, hospital stay, and hospital costs, the investigators said.

The authors reported that they had no disclosures.

Patients with alcohol use disorders who develop health care–associated infections have a 71% greater mortality risk, as well as longer hospital stays and higher hospital costs, than do those without alcohol use disorders who develop such infections, according to an analysis of data from a large inpatient database.

Photo credit: ©James Cox/Fotolia.com

The researchers studied the more than 32.7 million hospital discharges in the Nationwide Inpatient Sample for 2007, of which 149,982 developed a health care–associated infection and met inclusion criteria for the study. From the overall group, 4.7% were patients with an alcohol use disorder (AUD), while 5.9% of the cohort with a health care–associated infection also had an AUD codiagnosis, the researchers wrote. Having an AUD was found to be an independent predictor of increased mortality in the latter group (odds ratio 1.71), Dr. Marjolein de Wit of Virginia Commonwealth University, Richmond, and her colleagues reported online April 15 in Alcoholism: Clinical and Experimental Research.

An AUD diagnosis was also found to be an independent predictor of a 2-day increase in hospital length of stay (13 days in those with an AUD vs.11 days in those without). Hospital costs were about $7,500 higher ($34,826 vs. $27,167) for those AUD patients, the investigators said (Alcohol. Clin. Exp. Res. 2011 April 15 [doi: 10.1111/j.1530-0277.2011.01475.x]).

Prior studies have shown that the increased risk of health care infections in this population might be explained by cytokine abnormalities, impaired cell-mediated immune function, and aberrant innate immunity, they noted.

"Studies evaluating therapies aimed at decreasing the risk of developing health care–associated infections in patients with AUD are warranted," they concluded.

In the meantime, steps can be taken to reduce risk of developing health care–associated infections, according to Dr. Claudia Spies, of University Hospital Charite Universitaetsmedizin Berlin, whose earlier research was cited in the current study.

In a statement on the findings, Dr. Spies stressed the importance of external measures such as hand washing and head-of-bed elevation, and of the need for intrinsic measures such as therapeutic interventions specifically targeting hospitalized patients with AUDs. AUDs are factors intrinsic to patients, and thus preventing health care–associated infections in these patients requires such interventions, she explained.

Dr. Spies, along with Dr. de Wit, also emphasized the need for candid discussion about alcohol use with patients – despite the stigma they may feel.

"This is important both when a hospital admission is scheduled as well as at the time of an emergency hospital admission. In the case with scheduled surgeries, such as an elective surgery, one month preoperative abstinence may decrease the risk of health care–associated infections," Dr. de Wit said.

Follow-up care is also a necessity, she added, noting that patients will need anonymous data handling and help finding adequate intervention and treatment for their AUD.

The Nationwide Inpatient Sample for 2007 included hospital discharge data on adults aged 18 years and older. The investigators focused on those who developed pneumonia and/or sepsis, and excluded those who transferred from another health care facility, as well as those with immune suppression, cancer, or a community-acquired infection. Pneumonia was the most common health care–associated infection, occurring in 135,267 AUD patients, while sepsis occurred in 12,046, and both pneumonia and sepsis occurred in 2,579.

Alcohol use disorder designation was "based on an ICD diagnosis and encompassed alcohol dependence syndrome, alcohol abuse, and alcohol-induced mental disorders," the researchers explained.

The greater proportion of AUD patients in the subgroup of individuals with health care–associated infections, compared with the entire cohort, was not surprising; prior studies have demonstrated that AUD is common in hospitalized patients, and that it is associated with an increased risk of health care–associated infections. In fact, some studies have demonstrated rates of AUD up to 42% in hospitalized patients. Thus, given that the rates in this study were only 4.7% in all discharged patients and 5.9% in those with health care–associated infections (likely due to underdiagnosis, according to the investigators), it is likely that the effects of AUD in these patients are actually underestimated by this study, they said.

Although the study is limited by its retrospective design and the fact that the sample used has not been validated, the sample is large and likely representative, and the results indicate that patients with an AUD are disproportionately affected when it comes to mortality, hospital stay, and hospital costs, the investigators said.

The authors reported that they had no disclosures.