title: Diagnoses associated with the greatest years of potential life lost for in-hospital deaths in the United States, 1988-2010.
abstract: OBJECTIVE
  Premature mortality is a public health concern that can be quantified as years of potential life lost (YPLL). Studying premature mortality from in-hospital mortality can help guide hospital initiatives and resource allocation. This paper identified the diagnosis categories associated with in-hospital deaths that account for the highest YPLL and their trends over time.
  
  
  METHODS
  Retrospective review of the Nationwide Inpatient Sample (NIS), 1988-2010.
  
  
  METHODS
  Using the NIS, YPLL on patients hospitalized in the United States from 1988 to 2010 was calculated. Hospitalizations were categorized by related principal diagnoses using the Healthcare Cost and Utilization Project (HCUP) single-level Clinical Classification Software (CCS) definitions.
  
  
  RESULTS
  Between 1988 and 2010, total in-hospital estimated mortality of 20,154,186 people accounted for 198,417,257 YPLL (9.84 YPLL per in-hospital mortality; 8,626,837 estimated annual mean YPLL). The ten highest YPLL diagnosis categories accounted for 51% of the overall YPLL. The liveborn disease category (i.e., in-hospital live births) was the most common principal diagnosis and accounted for the highest YPLL at 1,070,053. The septicemia category accounted for the second highest YPLL at 548,922. The highest in-hospital mortality rate (20.8%) was associated with adult respiratory failure/insufficiency/arrest. The highest estimated in-hospital annual mean deaths occurred in patients with pneumonia at 69,134. For all in-hospital mortality, the inflation adjusted total in-hospital charges per YPLL was highest for acute myocardial infarction at $9292 per YPLL.
  
  
  CONCLUSIONS
  Using YPLL, a framework has been provided to compare the impact of premature in-hospital mortality from dissimilar diseases. The methodology and results may be used to help guide further investigation of hospital quality initiatives and resource allocation.
authors: Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA. Electronic address: rosenbb@ccf.org.
authors: B P
authors: BP
authors: Rosenbaum
authors: Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
authors: V R
authors: VR
authors: Kshettry
authors: Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
authors: M L
authors: ML
authors: Kelly
authors: Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA; Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, OH, USA.
authors: R J
authors: RJ
authors: Weil
mesh_terms: D000328:Adult; D000368:Aged; D002423:Cause of Death / Q000639:trends*; D005260:Female; D017722:Hospital Charges / Q000706:statistics & numerical data; D017052:Hospital Mortality / Q000639:trends*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008017:Life Expectancy / Q000639:trends*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
keywords: Nationwide inpatient sample; Premature mortality; Public health