Table 1.
Any Listed Age-Adjusted Coccidioidomycosis Hospitalization Rates Among American Indian/Alaska Natives (Indian Health Service) and the General US Population (National [Nationwide] Inpatient Sample), 2001–2014a
| AI/AN | US | |||||
|---|---|---|---|---|---|---|
| Characteristic | No. (%) | Rate (95% CI) | RR (95% CI) | No. [SE], (%) [SE] | Rate (95% CI) | RR (95% CI) |
| Sex | ||||||
| Male | 315 (60.1) | 47.7 (42.2–53.2) | Ref | 49 452 [2367], (61.7) [0.6] | 23.9 (22.9–25.0) | Ref |
| Female | 209 (39.9) | 27.6 (23.8–31.5) | 0.6d | 30 741 [1806], (38.3) [0.6] | 13.5 (12.7–14.2) | 0.6 (0.5–0.7) |
| Age group, yc | ||||||
| <18 | 12 (2.3) | 1.9 | Ref | 2740 [421], (3.4) [0.5] | 2.7 (1.9–3.5) | Ref |
| 18–44 | 208 (39.7) | 28.6 | 14.7 (8.2–26.4) | 25 355 [1429], (31.5) [0.7] | 16.0 (14.3–17.8) | 6.0 (4.1–8.0) |
| 45–64 | 224 (42.7) | 69.1 | 35.6 (19.9–63.7) | 29 991 [1523], (37.3) [0.5] | 28.0 (25.3–30.8) | 10.5 (7.2–13.9) |
| 65+ | 80 (15.3) | 64.7 | 33.3 (18.2–61.1) | 22 332 [1416], (27.8) [0.9] | 40.7 (35.6–45.7) | 15.3 (10.3–20.3) |
| IHS region | ||||||
| Southwest | 500 (95.4) | 91.5 (83.3–99.8) | 0.03d | NA | NA | NA |
| Other | 24 (4.6) | 3.1 (1.9–4.6) | Ref | NA | NA | NA |
| US region | ||||||
| Northeast | NA | NA | NA | 1291 [107], (1.6) [0.2] | 1.5 (1.3–1.8) | Unreliable |
| Midwest | NA | NA | NA | 2882 [170], (3.6) [0.3] | 3.0 (2.7–3.3) | Unreliable |
| South | NA | NA | NA | 5429 [328], (6.7) [0.5] | 3.4 (3.1–3.6) | Ref |
| West | NA | NA | NA | 70 960 [4078], (88.1) [0.7] | 72.4 (68.8–76.0) | Unreliable |
| Race | ||||||
| White | NA | NA | NA | 42 567 [2679], (56.1) [1.2] | 13.4 (12.7–14.2) | Ref |
| Black | NA | NA | NA | 8388 [500], (11.1) [0.4] | 16.4 (15.2–17.7) | 1.2 (0.9–1.5) |
| Hispanic | NA | NA | NA | 18 767 [1126], (24.7) [1.0] | 36.3 (34.1–38.5) | 2.7 (2.1–3.3) |
| A/PI | NA | NA | NA | 3008 [209], (4.0) [0.2] | 15.6 (14.0–17.2) | Unreliable |
| AI/AN | NA | NA | NA | 1849 [252], (2.4) [0.3] | 58.0 (49.5–66.6) | Unreliable |
| ICD-9-CM codec | ||||||
| Primary coccidioidomycosis (114.0) | 186 (35.5) | 13.1 (11.2–15.1) | 37 379 [2410], (46.4) [1.0] | 8.5 (8.0–9.0) | ||
| Primary extrapulmonary coccidioidomycosis (114.1) | 8 (1.5) | b | 504 [52], (0.6) [0.1] | 0.1 (0.1–0.1) | ||
| Coccidioidal meningitis (114.2) | 73 (13.9) | 5.1 (4.0–6.4) | 6773 [414], (8.4) [0.4] | 1.6 (1.5–1.7) | ||
| Other forms of progressive coccidioidomycosis (114.3) | 77 (14.7) | 5.4 (4.2–6.8) | 11 480 [666], (14.3) [0.5] | 2.7 (2.5–2.9) | ||
| Chronic pulmonary coccidioidomycosis (114.4) | 40 (7.6) | 3.0 (2.1–4.0) | 5913 [371], [7.3) [0.3] | 1.3 (1.2–1.4) | ||
| Pulmonary coccidioidomycosis, unspecified (114.5) | 81 (15.5) | 5.9 (4.6–7.4) | 11 567 [609], (14.4) [0.4] | 2.6 (2.5–2.8) | ||
| Coccidioidomycosis, unspecified (114.9) | 77 (14.7) | 5.2 (4.1–6.6) | 9365 [443], (11.6) [0.4] | 2.1 (2.0–2.3) | ||
| Died in the hospital | ||||||
| Died | 10 (1.9) | 3184 [195], (4.0) [0.2] | ||||
| Discharged alive | 514 (98.1) | 36.2 (33.0–39.4) | 77 313 [3963], (96.0) [0.2] | 17.7 (16.9–18.5) | ||
| Total | 524 | 37.0 (33.7–40.2) | 80 563 (4097) | 18.4 (17.6–19.3) |
Gamma confidence intervals were used when normal confidence intervals were unreliable.
Abbreviations: AI/AN, American Indian/Alaska Native; A/PI, Asian/Pacific Islander; CI, confidence interval; RR, rate ratio; SE, standard error.
aFirst-listed coccidioidomycosis hospitalization rate is expressed as the number of hospitalizations with coccidioidomycosis (International Classification of Diseases, 9th Revision, Clinical Modification code 114) listed as the first diagnosis on the hospital record per 1 000 000 corresponding population.
bData not presented with ≤5 hospitalizations for AI/ANs using Indian Health Service data. Age-adjusted rates not calculated on ≤20 hospitalization/visits.
cThe rates for age group and ICD-9-CM codes are crude rates and are not age-adjusted.
dAssociated P value <.05.