438 Seasonal Variations in Eosinophilic Esophagitis Related Hospitalizations: A Multiyear Analysis From the Largest Inpatient United States Database

Abstract

INTRODUCTION: Seasonal variations have been reported in the exacerbation of the eosinophilic esophagitis (EE), but there is conflicting data with no clear consensus. The pathogenesis of EE is believed to be immune/allergen mediated, including aeroallergens. This would support the theory of seasonal variations as other allergic conditions like asthma have been also shown to peak in Autumn. The purpose of our study is to analyze the seasonal variations in EE-related hospitalizations and hospital charges. METHODS: We conducted a cross-sectional study using the National Inpatient Sample (2008 to 2014), which is the largest US inpatient database. We used ICD-9-CM code (K200) to identify cases with a primary diagnosis of EE. Seasons were defined as follows: Winter (December-February); Spring (March-May); Summer (June–August); Autumn (September–November). The number and proportion of hospitalizations along with other outcome variables like mortality, length of stay (LOS) and hospitalization charges were compared and adjusted odds ratio for the outcome variables with regression analysis accounting for these confounders: age, gender, race, comorbidities, LOS, admission status and hospital factors including location and teaching status. All statistical analyses were performed with STATA. RESULTS: A total of 10,856 hospitalizations with a primary diagnosis of EE were reported between 2008 and 2014. Mean age of the population was 25.76 ± 0.78 years, and 34% were females. The highest number of EE-related hospitalizations were reported in summer (N = 2775; 25.5%) followed by winter (N = 2766; 25.4%), Autumn (N = 2749; 25.32%) and the least in spring season (N = 2565; 23.6%). In-hospital death was recorded in only 5 cases (0.04%). Mean length of stay was highest in the Spring as compared to the mean LOS for all seasons (3.73 vs. 3.30 days; P = 0.004). Hospitalization charges were highest in spring ($26403) versus a mean of $24826 over all four seasons (P = 0.336). CONCLUSION: We did not observe any statistically significant seasonal pattern in the number of EE-related hospitalizations. However, patients admitted during Spring (March, April, May) had significantly longer LOS. Economic costs per hospitalization were also highest in spring but were not statistically significant. This study is limited in that the analysis is based on the accuracy of diagnostic codes reported at the time of hospitalization.