Take-home Points
Study Question: What are the current epidemiologic data on adult pleural disease in the United States?
Results: Sex distribution in primary spontaneous pneumothorax has
Data were obtained from a family of US administrative databases published under the Healthcare Utilization Project13 by the Agency for Healthcare Research and Quality (Table 1).14, 15, 16, 17, 18 The baseline to describe demographic features related to pleural disease hospitalizations, ED treat-and-discharge (T&D) visits, and readmission events was 2016. Trends spanning 10 years were described for hospitalization and ED T&D events. Data from 2010 through 2016 were selected for the readmission
Across all pleural diseases and years, data were missing for the following inpatient admission variables: race (10.2%), total admission costs (4.0%), in-hospital death (0.07%), sex (0.03%), and LOS (0.005%). Similarly, data were missing for the following 30-day readmission variables: total readmission costs (2.4%); in-hospital death during readmission visit (0.04%); and for two ED care variables, charges (26%) and sex (0.02%). Finally, data from the Nationwide Ambulatory Surgery Sample are not
These analyses describe the contemporary landscape of pleural disease burden across various care delivery venues in US adults, thereby providing a novel and comprehensive perspective. That pleural disease-related hospitalization costs exceed $10 billion shows that pleural disease expenditures exceed those of more widely studied, yet less common, pulmonary conditions (eg, idiopathic pulmonary fibrosis26 [$1.8 billion] and sarcoidosis27 [$1.3-$8.7 billion]). By providing recent national estimates
In summary, these analyses suggest that trends in pleural disease are dynamic and that the clinical and economic burden associated with pleural disease in the United States exceeds that of some better studied pulmonary conditions. Various opportunities for enhanced management of pleural diseases are suggested. Study Question: What are the current epidemiologic data on adult pleural disease in the United States? Results: Sex distribution in primary spontaneous pneumothorax hasTake-home Points
Author contributions: S. R. M. contributed substantially to the conception, design, analysis, interpretation of data, and drafting of the work; approved the final version; and is the guarantor for the content of the manuscript, answerable for questions related to integrity, data, and analysis. J. K. S. contributed substantially to the design and drafting of the work, approved the final submitted version, and agrees to be accountable for all aspects of the work. R. L. contributed substantially
The introduction of pneumococcal conjugate vaccines (PCVs) into the US childhood immunization schedule in 2000 (7-valent PCV) was associated with reductions in parapneumonic empyema among children while existing trends in empyema among adults remained less affected [1]. The introduction of the 13-valent PCV (PCV13) in 2010 was also shown to be associated with further rapid initial reductions in empyema among US children [2–5]. However, whether PCV13 introduction was associated with declines in empyema among adults and whether the early changes observed among children were sustained remain unclear.
FUNDING/SUPPORT: This study was supported by the Cleveland Clinic's Center for Populations Health Research (CPHR) Q3 2019 award (#CPHR-2019-9).