Health care utilization and the cost of posttraumatic acute respiratory distress syndrome care

Robles, Anamaria J.; Kornblith, Lucy Z.; Hendrickson, Carolyn M.; Howard, Benjamin M.; Conroy, Amanda S.; Moazed, Farzad; Calfee, Carolyn S.; Cohen, Mitchell J.; Callcut, Rachael A.

doi:10.1097/ta.0000000000001926

Cited by 21 publications

(24 citation statements)

References 37 publications

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“…Additionally, we used existing data for hospitalization costs that are not necessarily specific to COVID-19. For example, the cost of ARDS decreased with age (since mortality increases with age, 30 older patients have a shorter hospital stay and therefore lower hospitalization costs), 31 which may not necessarily be the case for COVID-19. As another example, the studies that measured post-discharge costs for ARDS and sepsis included all health care costs and not just those specific to ARDS and sepsis.…”

Section: Covid-19mentioning

confidence: 99%

The Potential Health Care Costs And Resource Use Associated With COVID-19 In The United States

et al. 2020

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With the coronavirus disease 2019 pandemic, one of the major concerns is the burden COVID-19 will impose on the United States (U.S.) health care system. We developed a Monte Carlo simulation model representing the U.S. population and what can happen to each person who gets infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV2). We estimate resource use and direct medical costs per infection and at the national level, with various "attack rates" (infection rates) to understand the potential economic benefits of reducing the burden of the disease. A single symptomatic COVID-19 infection would cost a median of $3,045 in direct medical costs incurred only during the course of the infection. Eighty percent of the U.S. population getting infected could result in a median of 44.6 million hospitalizations, 10.7 million ICU admissions, 6.5 million ventilators used, and 249.5 million hospital bed days, costing $654.0 billion in direct costs over the course of the pandemic. If 20% were to become infected, there would be a median of 11.2 million hospitalizations, 62.3 million hospital bed days, and 1.6 million ventilators used, costing $163.4 billion.

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Section: Covid-19mentioning

confidence: 99%

The Potential Health Care Costs And Resource Use Associated With COVID-19 In The United States

et al. 2020

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“…Acute Lung Injury (ALI) describes collectively the pathologic changes observed in ARDS lungs. Over 10% of all ICU patients meet criteria for ARDS [ 2 ] and more than 200,000 cases are diagnosed annually in the U.S. [ 1 ], costing over $434,000 per hospital stay [ 3 ]. Despite advances in critical care, no effective treatments for ARDS exist at this time, and non-specifically targeted anti-inflammatory therapies have largely failed to improve mortality [ 4 – 9 ], which approximates 40% [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

IL-10 and class 1 histone deacetylases act synergistically and independently on the secretion of proinflammatory mediators in alveolar macrophages

et al. 2021

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Introduction Anti-inflammatory cytokine IL-10 suppresses pro-inflammatory IL-12b expression after Lipopolysaccharide (LPS) stimulation in colonic macrophages, as part of the innate immunity Toll-Like Receptor (TLR)-NF-κB activation system. This homeostatic mechanism limits excess inflammation in the intestinal mucosa, as it constantly interacts with the gut flora. This effect is reversed with Histone Deacetylase 3 (HDAC3), a class I HDAC, siRNA, suggesting it is mediated through HDAC3. Given alveolar macrophages’ prominent role in Acute Lung Injury (ALI), we aim to determine whether a similar regulatory mechanism exists in the typically sterile pulmonary microenvironment. Methods Levels of mRNA and protein for IL-10, and IL-12b were determined by qPCR and ELISA/Western Blot respectively in naïve and LPS-stimulated alveolar macrophages. Expression of the NF-κB intermediaries was also similarly assessed. Experiments were repeated with AS101 (an IL-10 protein synthesis inhibitor), MS-275 (a selective class 1 HDAC inhibitor), or both. Results LPS stimulation upregulated all proinflammatory mediators assayed in this study. In the presence of LPS, inhibition of IL-10 and/or class 1 HDACs resulted in both synergistic and independent effects on these signaling molecules. Quantitative reverse-transcriptase PCR on key components of the TLR4 signaling cascade demonstrated significant diversity in IL-10 and related gene expression in the presence of LPS. Inhibition of IL-10 secretion and/or class 1 HDACs in the presence of LPS independently affected the transcription of MyD88, IRAK1, Rela and the NF-κB p50 subunit. Interestingly, by quantitative ELISA inhibition of IL-10 secretion and/or class 1 HDACs in the presence of LPS independently affected the secretion of not only IL-10, IL-12b, and TNFα, but also proinflammatory mediators CXCL2, IL-6, and MIF. These results suggest that IL-10 and class 1 HDAC activity regulate both independent and synergistic mechanisms of proinflammatory cytokine/chemokine signaling. Conclusions Alveolar macrophages after inflammatory stimulation upregulate both IL-10 and IL-12b production, in a highly class 1 HDAC-dependent manner. Class 1 HDACs appear to help maintain the balance between the pro- and anti-inflammatory IL-12b and IL-10 respectively. Class 1 HDACs may be considered as targets for the macrophage-initiated pulmonary inflammation in ALI in a preclinical setting.

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“…Acute respiratory distress syndrome was determined using the Berlin Definition, 29 which included blinded, two-physician adjudication of chest radiographs during the first 8 days of admission as previously described. 30 Multiorgan failure was defined using the Denver Postinjury Multiple Organ Failure Score. 31 Changes in coagulability over hospital course, VTE occurrence, and timing of chemoprophylaxis initiation were analyzed.…”

Section: Methodsmentioning

confidence: 99%

Dynamic coagulability after injury: Is delaying venous thromboembolism chemoprophylaxis worth the wait?

Sumislawski

Kornblith

Conroy

et al. 2018

J Trauma Acute Care Surg

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Health care utilization and the cost of posttraumatic acute respiratory distress syndrome care

Abstract: Economic and value-based evaluations, level IV.

Cited by 21 publications

References 37 publications

The Potential Health Care Costs And Resource Use Associated With COVID-19 In The United States

The Potential Health Care Costs And Resource Use Associated With COVID-19 In The United States

IL-10 and class 1 histone deacetylases act synergistically and independently on the secretion of proinflammatory mediators in alveolar macrophages

Dynamic coagulability after injury: Is delaying venous thromboembolism chemoprophylaxis worth the wait?

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