1013 Length of stay and hospitalization costs in women with depression or anxiety admitted for hyperemesis

Abstract

Perinatal depression and anxiety are common, and have been associated with increased length of stay (LOS) and hospital costs in patients with other comorbid conditions. Our objective is to assess LOS and hospital costs in women with depression and anxiety admitted for hyperemesis gravidarum (HEG). We performed a retrospective cohort study using the National Inpatient Sample comparing hospitalizations for HEG or nausea and vomiting of pregnancy (NVP) of women age 12-55 with and without a history of depression, anxiety, or bipolar depression in 2012-2016. Ectopic and molar pregnancies, spontaneous abortions, and terminations were excluded. International Classification of Disease 9th and 10th edition diagnosis and procedure codes were used to identify our cohort and outcomes. The primary outcomes were maternal LOS and total cost of hospitalization. Secondary outcomes included maternal comorbidities and hospital characteristics. Univariate analyses were performed for all primary and secondary outcomes, and multivariate regression was performed for LOS and total cost of hospitalization, controlling for confounding variables. 42,745 hospitalizations for HEG or NVP were identified, 6,850 (16%) of whom had documented depression, anxiety, or bipolar depression. Women with depression or anxiety had a significantly longer LOS (p < 0.001) and significantly higher total hospitalization cost (p < 0.001) compared to women without such history. In multivariate regression, depression or anxiety was associated with an increased risk of LOS > 3 days (aOR 1.50 / 95% CI 1.37 – 1.64) and total hospital cost > $4,000 (aOR 1.56 / 95% CI 1.42 – 1.71). After controlling for pre-existing conditions and hospital characteristics, a diagnosis of depression, anxiety, or bipolar depression was associated with statistically significantly increased length of hospital stay and greater total hospital costs in women admitted for HEG or NVP, though these differences are small and may not be clinically significant.View Large Image Figure ViewerDownload Hi-res image Download (PPT)