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Résumé Introduction: Les infections urinaires (IU) sont les infections bactériennes les plus fréquentes chez les patients hospitalisés. Cette étude décrit les tendances temporelles d'admission et de mortalité liées aux hospitalisations pour les IU, ainsi que le fardeau économique associé. Les prédicteurs de mauvaise évolution clinique et de mortalité sont examinés par la suite. Méthodes: Les données ont été extraites à partir de la base de données du NIS entre le 1er janvier 1998 et le 31 décembre 2010. 1,717,181 hospitalisations liées aux IU ont été retenues. L'incidence et la mortalité ont été calculées et stratifiées selon le sexe, l'âge et la présence de sepsis. Les frais médians et totaux pour les hospitalisations sont calculés et ajustés pour l'inflation. Finalement, les prédicteurs d'avoir un sepsis induit par les IU et de mortalité sont examinés avec une analyse par régression logistique multivariée. Résultats: L'incidence globale d'hospitalisation et la mortalité associées aux IU voit une croissance annuel estimé (EAPC) de +4.764 et +4.610 respectivement (p, Introduction: Urinary tract infections (UTIs) are the most common bacterial infections in hospitalized patients. This study describes the temporal trends of admissions and mortality, as well as the economic burden of UTI-associated hospitalizations. Predictors of having severe disease as well as predictors of mortality were also examined. Methods: Data were retrieved from the Nationwide Inpatient Sample between 1998 and 2010, yielding a weighted sample of 1,717,181 UTI-associated admissions. Incidence and mortality rates were calculated and stratified according to gender, age, and the presence of sepsis. The median and total charges of hospitalization were calculated and adjusted for inflation. Finally, predictors of UTI induced sepsis and mortality were examined using logistic regression models. Results: The overall incidence and mortality of UTI-admissions has been increasing with an EAPC of +4.764 and +4.610 respectively (p

OBJECTIVES To examine the ability of the threshold recommended by the National Comprehensive Cancer Network (NCCN) in correctly predicting histologically-confirmed lymph node invasion (LNI). The 2010 NCCN practice guidelines for prostate cancer recommend a pelvic lymph node dissection (PLND) at radical prostatectomy in all individuals with a nomogram predicted LNI risk of >= 2%. PATIENTS AND METHODS We assessed 20 877 patients who were treated with radical prostatectomy and PLND between 2004 and 2006, within the Surveillance, Epidemiology and End Results database. The 2% nomogram threshold, as well as other threshold values (range 1-10%) were tested. Finally, we externally validated the NCCN guideline nomogram. RESULTS Overall, 2.5% of patients had LNI. The use of the 2% threshold would allow the avoidance of 23% of PLNDs, at the cost of missing 1.7% of patients with LNI. Conversely, the use of a 3% threshold would allow the avoidance of 58% of PLNDs, at the cost of missing 15% of patients with LNI vs 72% and 26%, respectively, for the 4% threshold. Overall, the accuracy of the NCCN guideline nomogram quantified according to the receiver-operator characteristics-derived area under the curve was 82%. CONCLUSIONS In a population-based sample, the NCCN guideline nomogram is highly accurate. However, the 2% threshold will permit the avoidance of only 23% of PLNDs, instead of the 48% intended by the NCCN guidelines. The use of a 3% threshold may allow a lower rate of PLND overtreatment, although it will miss more patients with LNI.

BACKGROUND: Previous reports indicated that African-American men with testicular germ cell tumors (TGCTs) have more aggressive tumor characteristics and less favorable outcomes than other men. The authors of this report evaluated the effects of race and socioeconomic status (SES) on stage distribution, overall mortality (OM), and cancer-specific mortality (CSM) in men with TGCTs. METHODS: The Surveillance, Epidemiology, and End Results (SEER) database was used to identify 22,553 men who were diagnosed with TGCTs between 1988 and 2006. Kaplan-Meier and Cox regression analyses were generated to predict OM and CSM. Covariates of the analyses included race, SES, age, histologic subtype, disease stage, procedure type, SEER registry, and year of diagnosis. The interaction between race and SES also was examined. RESULTS: Overall, there were 516 African-American men, 21,090 Caucasian men, and 947 men of other races. African-Americans (14.9%) and individuals with low SES (10.7%) had a higher proportion of distant stage disease. CSM and OM rates were significantly higher for African-American patients and for patients who resided in low SES counties. Multivariate analyses revealed that African-American men and men with low SES were more likely to die of OM and CSM relative to Caucasian men (P < .001) and men with high SES (P < .001), respectively. The interaction between race and SES was not significant. CONCLUSIONS: African-American race and low SES appeared to predispose men to more advanced disease stages and to higher OM and CSM rates. These observations may warrant race-specific and/or SES-specific adjustments in the treatment of TGCT. Cancer 2011;. © 2011 American Cancer Society.

The detrimental effect of unmarried marital status on stage and survival has been confirmed in several malignancies. We set to test whether this applied to patients diagnosed with prostate cancer (PCa) treated with radical prostatectomy (RP). We identified 163,697 non-metastatic PCa patients treated with RP, within 17 Surveillance, Epidemiology, and End Results registries. Logistic regression analyses focused on the rate of locally advanced stage (pT3-4/pN1) at RP. Cox regression analyses tested the relationship between marital status and cancer-specific (CSM), as well as all-cause mortality (ACM). Respectively, 9.1 and 7.8% of individuals were separated/divorced/widowed (SDW) and never married. SDW men had more advanced stage at surgery (odds ratio: 1.1; p