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A Nationwide Study of Inpatient Admissions, Mortality, and Costs for Patients with Cirrhosis from 2005 to 2015 in the USA.

Authors
  • Zou, Biyao1
  • Yeo, Yee Hui1
  • Jeong, Donghak1
  • Park, Haesuk2
  • Sheen, Edward1
  • Lee, Dong Hyun1, 3
  • Henry, Linda1
  • Garcia, Gabriel1
  • Ingelsson, Erik4, 5
  • Cheung, Ramsey1, 6
  • Nguyen, Mindie H7
  • 1 Division of Gastroenterology and Hepatology, Stanford University Medical Center, 750 Welch Road, Suite 210, Palo Alto, CA, 94304, USA.
  • 2 Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, Gainesville, FL, USA.
  • 3 Good Gang An Hospital, Busan, South Korea. , (North Korea)
  • 4 Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
  • 5 Stanford Cardiovascular Institute, Stanford University, Stanford, CA, USA.
  • 6 Division of Gastroenterology and Hepatology, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.
  • 7 Division of Gastroenterology and Hepatology, Stanford University Medical Center, 750 Welch Road, Suite 210, Palo Alto, CA, 94304, USA. [email protected]
Type
Published Article
Journal
Digestive Diseases and Sciences
Publisher
Springer-Verlag
Publication Date
May 01, 2020
Volume
65
Issue
5
Pages
1520–1528
Identifiers
DOI: 10.1007/s10620-019-05869-z
PMID: 31598919
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Liver cirrhosis is a substantial health burden in the USA, but population-based data regarding the trend and medical expenditure are limited and outdated. We investigated the trends of inpatient admissions, costs, and inpatient mortality from 2005 to 2015 among cirrhotic patients. A retrospective analysis was conducted using the National Inpatient Sample database. We adjusted the costs to 2015 US dollars using a 3% inflation rate. National estimates of admissions were determined using discharge weights. We identified 1,627,348 admissions in cirrhotic patients between 2005 and 2015. From 2005 to 2015, the number of weighted admissions in cirrhotic patients almost doubled (from 505,032 to 961,650) and the total annual hospitalization cost in this population increased three times (from 5.8 to 16.3 billion US dollars). Notably, admission rates varied by liver disease etiology, decreasing from 2005 to 2015 among patients with hepatitis C virus (HCV)-related cirrhosis while increasing (almost tripled) among patients with nonalcoholic fatty liver disease (NAFLD)-related cirrhosis. The annual inpatient mortality rate per 1000 admissions overall decreased from 63.8 to 58.2 between 2005 and 2015 except for NAFLD (27.2 to 35.8) (P < 0.001). Rates and costs of admissions in cirrhotic patients have increased substantially between 2005 and 2015 in the USA, but varied by liver disease etiology, with decreasing rate for HCV-associated cirrhosis and for HBV-associated cirrhosis but increasing for NAFLD-associated cirrhosis. Inpatient mortality also increased by one-third for NAFLD, while it decreased for other diseases. Cost also varied by etiology and lower for HCV-associated cirrhosis.

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