Phoenixville Hospital

Introduction: Acute eosinophilic pneumonia (AEP) is a rare, rapidly progressive pulmonary disorder that can lead to acute respiratory failure requiring ICU-level support and invasive mechanical ventilation (IMV). Although case reports and small series have described its clinical course, national-level data on hospitalization patterns, illness severity, and resource utilization remain limited. We aimed to fill this research gap. Methods: We analyzed adult hospitalizations with a primary diagnosis of AEP(ICD-10 codes) from the 2022 Nationwide Readmissions Database. Survey weights were applied to generate nationally representative estimates. Illness severity was categorized into three mutually exclusive groups: floor admission, ICU admission without intubation, and ICU admission with intubation. Primary outcomes included in-hospital mortality, length of stay (LOS), and total hospital charges. Seasonal variation and the prevalence of comorbid asthma and gastroesophageal reflux disease (GERD) were also assessed. Descriptive statistics and survey-weighted subgroup comparisons were performed. Results: A total of 10,035 weighted hospitalizations (n = 3,912 unweighted) were identified. The median age was 60 years (IQR: 45–72), and 61.2% of the participants were female. Asthma and GERD were significantly more prevalent in AEP hospitalizations compared to non-AEP hospitalizations (58.9% vs. 7.0% and 30.8% vs. 16.2%, respectively; p < 0.001). AEP discharges peaked in November (18.5%), with seasonal clustering from June to October and less frequent from January to March. ICU admission occurred in 42%, and 14.1% required IMV. LOS ranged from 4.8 to 8.0 days, and charges from $59,198 to $170,057, increasing with severity. Mortality was 0.24% (floor), 0.26% (ICU without IMV), and 4.18% (ICU with IMV). Conclusions: In our study, AEP hospitalizations show a clear severity-outcome gradient, with higher ICU use, ventilation need, mortality, and cost as illness advances. These findings highlight AEP as a resource-intensive condition with a substantial impact on survival in severe cases. Although asthma and GERD were common, their impact on outcomes was not assessed, and treatment data were not available. Early recognition and triage based on severity may reduce resource burden and improve outcomes.

Excessive surgical bleeding is a potential risk in patients taking ticagrelor who must undergo urgent cardiothoracic (CT) surgery before adequate washout of the drug can occur. The DrugSorb-Antithrombotic removal (ATR) device is a polymer sorbent-filled hemoadsorption cartridge that can remove unbound (active) fractions of ticagrelor and ticagrelor active metabolite (TAM) from blood. STAR-T was a randomized double-blind sham-controlled clinical trial investigating whether the intraoperative use of the device could reduce perioperative bleeding complications in patients undergoing CT surgery within 2 days of ticagrelor discontinuation. Blood samples were collected during the study for total drug level measurements because the ability to measure unbound ticagrelor and TAM (0.2% of total levels) requires an ultra-high sensitivity assay, which is not commercially available. A published and validated pharmacokinetic (PK) model was used to explore the effect of the device on unbound ticagrelor/TAM using the total drug concentrations from the study. The model performed well for simulations of total ticagrelor and TAM, which indicated that the unbound concentrations were also appropriate. The model demonstrated that DrugSorb-ATR significantly reduced unbound ticagrelor and TAM concentrations. Linear and logistic regression analyses of summed ticagrelor and TAM concentrations showed that the DrugSorb-ATR device reduced the probability of clinically relevant bleeding in STAR-T because of the reduction in unbound ticagrelor and TAM.