Sociodemographic Factors Associated with Patients Hospitalized for Coccidioidomycosis in California and Arizona, State Inpatient Database 2005-2011 Open Access
Kupferwasser, Deborah (Summer 2018)
Published
Abstract
Background: Coccidioidomycosis is endemic in the Southwestern United States. Disseminated infection can be life-threatening and is responsible for hospitalization and healthcare resource utilization. There are limited data evaluating factors associated with coccidioidomycosis hospitalization.
Methods: We conducted a cross-sectional study to assess sociodemographic and comorbidity factors associated with hospitalization due to coccidioidomycosis in California and Arizona compared to hospitalization for other causes. We analyzed hospital discharge data obtained from the State Inpatient Dataset (SID) for both California and Arizona for years 2005-2011. Multivariable logistic regression modeling was used to analyze factors associated with coccidioidomycosis.
Results: A total of 23,758 hospitalizations due to coccidioidomycosis occurred during the study period in the two states. Arizona had an over six-fold higher coccidioidomycosis hospitalization incidence rate compared to California, 198.9 vs 29.6/per 100,000-person years. In the multivariable model patients aged (40-49) years had a higher odds of hospitalization due to coccidioidomycosis vs young adults (18-29) years (aOR=1.50 [95% CI 1.43-1.59]). African Americans had higher odds of hospitalization due to coccidioidomycosis vs. Caucasians (aOR= 1.98 [95% CI 1.89-2.06]). Residing in a large rural town had a higher odds of hospitalization due to coccidioidomycosis vs residing in an urban area (aOR=2.28 95% [CI 2.19-2.39]). Higher comorbidities were associated with an increased odds for hospitalization due to coccidioidomycosis (aOR=1.02 [95% CI 1.02-1.03]) for each point in the Elixhauser score). Uncomplicated diabetes and chronic pulmonary disease was also associated with hospitalization due to coccidioidomycosis (aOR=1.47 [95% CI 1.41-1.52] and (aOR=1.59 [95% CI 1.54-1.65]), respectively.
Conclusions: We found sociodemographic factors and comorbidities associated with hospitalizations due to coccidioidomycosis compared to hospitalization due to other causes. Identifying persons at highest risk for hospitalization with coccidioidomycosis may be helpful for future prevention efforts.
Table of Contents
Introduction……………………………………………………………………………….………1
Historical prospective…………………………………………………………….……….1
Pathogen lifestyle and characteristics…………….……………………………….………3
Pathogenesis………………………………………………………………………….……4
Coccidioidomycosis clinical presentation and course…………………………………….5
Pulmonary coccidioidomycosis…………………………………..……………….………6
Extrapulmonary coccidioidomycosis…………………………………………….………..6
Diagnosis…………………………………………………………………………………..7
Vaccine Development……………………………………………………………………..8
Treatment…………………………………………………………..…………….……..…9
Risk factors for severe and disseminated disease……………………………….………...9
Manuscript……………………………………………………………………………………….11
Introduction………………………………………..…….....………………………….…11
Methods………………………………………………………………….……………….12
Results……………………………………………………………………………………16
Discussion…………………….………………………………………………………….20
Expanded discussion……………………………………………………………………………..24
References……………………………………………………………………….……………….29
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