PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection

Permanent URI for this collectionhttps://hdl.handle.net/20.500.11779/1928

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  • Article
    Citation - Scopus: 10
    Patterns of Treatment and Correction of Hyponatremia in Intensive Care Unit Patients
    (W.B. Saunders, 2015-10-01) Badawi, Omar; Chiodo, Joseph; Waikar, Sushrut S.; Boklage, Susan; Dasta, Joseph; Xie, Lin; Başer, Onur
    Purpose: The goal of this study was to examine the real-world patterns of care and interventions among intensive care unit (ICU) patients with hypervolemic and euvolemic hyponatremia using a large clinical database. Materials and Methods: The Phillips eICU Research Institute database was used to investigate hyponatremia treatment patterns and trends, mortality, and ICU and hospital length of stay. Demographics, clinical characteristics, and outcome variables were compared in patients corrected for hyponatremia using both a more strict and a less strict definition. Results: At admission, 35%, 55%, and 10% of patients had mild, moderate, and severe hyponatremia, respectively. At the end of an ICU stay, the percentage of patients who did not have corrected serum sodium concentration was 48% (using a more strict definition) and 24% (using a less strict definition). Using either definition of correction, patients with serum sodium correction had lower mortality and longer survival than did patients without corrected serum sodium concentration. Conclusions: A significant proportion of hyponatremia is not corrected during an ICU stay. Critically ill patients with hyponatremia who have their serum sodium corrected have lower mortality and longer survival, highlighting the need for more attention to hyponatremia and its correction in critically ill patients. © 2015 Elsevier Inc.
  • Article
    Citation - WoS: 7
    Citation - Scopus: 8
    The Use of Decomposition Methods in Real-World Treatment Benefits Evaluation for Patients With Type 2 Diabetes Initiating Different Injectable Therapies: Findings From the Initiator Study
    (Elsevier Science Inc, 2017-12-01) Ke, Xuehua; Buysman, Erin; Wei, Wenhui; Xie, Lin; Grabner, Michael; Brekke, Lee; Başer, Onur
    Background: Determining characteristics of patients likely to benefit from a particular treatment could help physicians set personalized targets. OBJECTIVES: To use decomposition methodology on real-world data to identify the relative contributions of treatment effects and patients' baseline characteristics. METHODS: Decomposition analyses were performed on data from the Initiation of New Injectable Treatment Introduced after Antidiabetic Therapy with Oral-only Regimens (INITIATOR) study, a real-world study of patients with type 2 diabetes started on insulin glargine (GLA) or liraglutide (LIRA). These analyses investigated relative contributions of differences in baseline characteristics and treatment effects to observed differences in 1-year outcomes for reduction in glycated hemoglobin A1c (HbA1c) and treatment persistence. RESULTS: The greater HbA1c reduction seen with GLA compared with LIRA (-1.39% vs. -0.74%) was primarily due to differences in baseline characteristics (HbA1c and endocrinologist as prescribing physician; P < 0.050). Patients with baseline HbA1c of 9.0% or more or evidence of diagnosis codes related to mental illness achieved greater HbA1c reductions with GLA, whereas patients with baseline polypharmacy (6-10 classes) or hypogylcemia achieved greater reductions with LIRA. Decomposition analyses also showed that the higher persistence seen with GLA (65% vs. 49%) was mainly caused by differences in treatment effects (P < 0.001). Patients 65 years and older, those with HbA1c of 9.0% or more, those taking three oral antidiabetes drugs, and those with polypharmacy of more than 10 classes had higher persistence with GLA; patients 18 to 39 years and those with HbA1c of 7.0% to less than 8.0% had higher persistence with LIRA. CONCLUSIONS: Although decomposition does not demonstrate causal relationships, this method could be useful for examining the source of differences in outcomes between treatments in a real-world setting and could help physicians identify patients likely to respond to a particular treatment. Copyright (C) 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.