Incidence of Peptic Ulcer Bleeding in the US Pediatric Population
The aim of the present study was to determine the incidence of peptic ulcer bleeding (PUB) in pediatric patients.
A hospital inpatient database, Premier Perspective, and an insurance claims database, MarketScan, were analyzed to estimate upper and lower limits for the annual incidence of PUB in the US pediatric population.
Using data from the Premier Perspective database and database-specific projection methodology, the total number of cases of hospitalization of pediatric patients for PUB in the United States in 2008 was estimated to be between 378 and 652. This translated to an incidence of 0.5 to 0.9/100,000 individuals in the pediatric population. Using data from the MarketScan database, the incidence of PUB in the insured pediatric population was estimated to be 4.4/100,000 individuals. Overall, 17.4% of insured pediatric patients diagnosed as having any upper gastrointestinal ulcer in 2008 were reported to have developed PUB.
The estimated incidence of PUB in the US pediatric population in 2008 ranged from 0.5 to 4.4/100,000 individuals. The total number of cases of PUB in pediatric patients in the United States each year was thus estimated to be between 378 and 3250. Such estimates provide a likely lower and upper limit for the total number of cases of the condition annually.
Available from: PubMed Central
- "This database, with its >20 million lives with continuous enrollment in any given year, its ability to track patients longitudinally across all sites of care over multiple years, and unique projection methodology, is a valuable tool to estimate frequency of diseases and surgeries. This database has recently been used for a number of disease prevalence and incidence estimates8,9 and was referenced in more than 50 peer-reviewed manuscripts in 2012 alone.10 "
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Endoscopic sinus surgery for patients with chronic rhinosinusitis (CRS) unresponsive to medical therapy has traditionally been performed under general anesthesia and in the operating room. Balloons for catheter dilation of paranasal sinuses were introduced in 2005, allowing sinus surgery to be safely performed either in the operating room or the office care setting, under local anesthesia. This change in care setting has raised concerns of overuse or expanded indications for sinus surgery. This study was thus designed to evaluate changes in surgical volumes in the United States, for the period 2006–2011, and to evaluate the impact of the sinus balloons on surgical practice.
The MarketScan® Commercial Claims and Encounter Database was queried for the period 2006 to 2011 using CRS International Classification of Diseases, Ninth Revision codes (473.X) and sinus surgery US-based Common Procedural Terminology (CPT) codes (endoscopic sinus surgery: CPT codes 31254–31294 and 31299; balloon catheter dilation: CPT codes 31295–31297). MarketScan’s projection methodology was applied to estimate the nationwide prevalence of CRS and the incidence of sinus surgery. Procedural case mix and total average payment per surgery were analyzed.
From 2006 to 2011, the yearly prevalence of CRS and sinus surgery volume remained flat with ~430 patients with CRS per 100,000 in the employer-sponsored insured population, of which ~117/100,000 underwent surgery. In 2006, 2.69 paranasal sinuses (95% confidence interval [95% CI]: 2.65–2.71) were treated during each individual sinus surgery, with an additional 1.11 nasal procedures (95% CI: 1.08–1.13) performed concurrently. By 2011, the procedural case mix had expanded to 2.90 sinus (95% CI: 2.87–2.93) and 1.16 nasal procedures (95% CI: 1.14–1.85) per surgery. Payments increased from $7,011.06 (α=$6,378.30; β=3.1490) in 2006 to $9,090.11 (α=$8,350.20; β=2.9535) in 2011, in line with US medical inflation.
In the study population, approximately 1 in 3.7 patients diagnosed with CRS underwent sinus surgery. This ratio remained constant from 2006 to 2011. There was no evidence that the number of distinct sinus surgeries per 100,000 people increased despite the introduction and utilization of balloon catheter dilation tools that enabled migration of sinus surgery to the office.
Available from: synapse.koreamed.org
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ABSTRACT: Gastric ulcers are rare in children and are typically seen in cases of Helicobacter pylori (H. pylori) infection, non-steroidal anti-inflammatory drugs (NSAIDs) use, and critical illnesses such as sepsis. The risk of a bleeding ulcer due to use of NSAIDs is dependent on the dose, duration, and the individual NSAIDs, but the bleeding may occur soon after the initiation of NSAID therapy. An experience is described of a 16-month-old infant with a bleeding gastric ulcer after taking the usual dosage of ibuprofen for 3 days. The infant was also successfully treated with endoscopic hemostasis. Even a small amount of ibuprofen may be associated with bleeding gastric ulcers in infant.
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